Individual
ANTONISE CLESIDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10560 WEST STATE ROAD 84, COCONUT CREEK, FL 33063
(954) 634-3636
Mailing address
10560 WEST STATE ROAD 84, COCONUT CREEK, FL 33063
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014044000
—
FL
Enumeration date
02/24/2015
Last updated
02/24/2015
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