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Individual

BENJAMIN MIKELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
(352) 374-5608
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA248502
FL

Other

Enumeration date
10/25/2012
Last updated
10/25/2012
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