Individual
DENIS SOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
72 PALMER ST, ST AUGUSTINE, FL 32084-3452
(305) 900-8524
Mailing address
72 PALMER ST, ST AUGUSTINE, FL 32084-3452
(305) 900-8524
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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