Individual
EBONY LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12623 SW SR 45, ARCHER, FL 32618-5682
(352) 225-0142
Mailing address
12623 SW SR 45, ARCHER, FL 32618-5682
(352) 225-0142
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA54803
FL
Other
Enumeration date
05/01/2026
Last updated
05/01/2026
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