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Individual

MS. VILNA D JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1950 SE PORT ST LUCIE BLVD STE 212, PORT ST LUCIE, FL 34952-5579
(772) 446-4871
Mailing address
1950 SE PORT ST LUCIE BLVD STE 212, PORT ST LUCIE, FL 34952-5579
(772) 446-4871

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
238668
FL
376J00000X
Homemaker
Primary
238668

Other

Enumeration date
08/23/2023
Last updated
08/23/2023
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