Individual
FREDRIEKA ALICIA LATOYA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5304 MILE STRETCH DR, HOLIDAY, FL 34690-6060
(877) 202-1191
Mailing address
7751 NW 41ST ST, HOLLYWOOD, FL 33024-8415
(954) 643-0278
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9305674
FL
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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