Individual
EBONY MONICK LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 WASHINGTON PALM LOOP APT A, DAVENPORT, FL 33897-1641
(407) 865-1876
Mailing address
304 WASHINGTON PALM LOOP APT A, DAVENPORT, FL 33897-1641
(407) 865-1876
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
FL
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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