Individual
MS. JUANITA FAY CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1448 NE 816 AVE, OLD TOWN, FL 32680-6506
(352) 542-1378
Mailing address
1448 NE 816 AVE, OLD TOWN, FL 32680-6506
(352) 542-1378
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
FL
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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