Individual
STEPHANIE KISSOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7710 NW 71ST CT, TAMARAC, FL 33321-2973
(954) 758-8725
Mailing address
1305 NE 12TH ST, FORT LAUDERDALE, FL 33304-2256
(954) 909-8386
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5243526
FL
Other
Enumeration date
09/23/2024
Last updated
10/01/2024
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