Individual
MR. RAPHAEL SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
11150 4TH ST N, #4502, ST PETERSBURG, FL 33716-2914
(813) 793-1579
Mailing address
11150 4TH ST N, #4502, ST PETERSBURG, FL 33716-2914
(813) 793-1579
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5182360
FL
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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