Individual
ELLENNE CHERISOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3903 DR MARTIN LUTHER KING BLVD, FORT MYERS, FL 33916-4805
(754) 900-9981
Mailing address
3903 DR MARTIN LUTHER KING BLVD, FORT MYERS, FL 33916-4805
(754) 900-9981
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
FL
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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