Individual
MADGIANNA GRANT-SOMMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1900 S HARBOR CITY BLVD, SUITE 231, MELBOURNE, FL 32901-4749
(321) 821-7793
(321) 821-0847
Mailing address
867 SANTO DOMINGO AVE SW, PALM BAY, FL 32908-7436
(321) 914-6289
(321) 821-0847
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1164641
FL
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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