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Individual

REBECCA LEE FITZGERALD CHAMPION

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1116 NIKKI VIEW DR, BRANDON, FL 33511-4868
(855) 832-6727
Mailing address
7954 ASHLEY POINTE DR, LAKELAND, FL 33810-1346
(863) 370-3994

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
03/29/2018
Last updated
03/29/2018
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