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Individual
SHENEKA VACQUANA DESLEE MORTLEY
Active
Individual
SHENEKA VACQUANA DESLEE MORTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TRN16022
FL
Other
Enumeration date
05/10/2011
Last updated
10/24/2019
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