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Individual

LOVELY ROBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
927 GLOUCESTER CT, KISSIMMEE, FL 34758-2609
(863) 205-0016
(407) 530-4278
Mailing address
927 GLOUCESTER CT, KISSIMMEE, FL 34758-2609
(863) 205-0016
(407) 530-4278

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906960
FL

Other

Enumeration date
10/09/2018
Last updated
10/09/2018
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