Individual
JUDITH DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA20772
Contact information
Practice address
250 INTERNATIONAL PKWY, LAKE MARY, FL 32746-5030
(800) 806-6026
Mailing address
PO BOX 127, CAPE CANAVERAL, FL 32920-0127
(321) 243-2020
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA20772
FL
Other
Enumeration date
12/24/2008
Last updated
12/24/2008
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