Individual
JAZZY-MAE NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
(813) 827-9870
Mailing address
6401 S WEST SHORE BLVD APT 1403, TAMPA, FL 33616-1395
(719) 569-1757
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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