Individual
AMY LEE AVILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2344 SW SAVONA BLVD, PORT ST LUCIE, FL 34953-2215
(772) 475-3457
Mailing address
2344 SW SAVONA BLVD, PORT ST LUCIE, FL 34953-2215
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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