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Individual

FLORANTE JACINTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
906 S MAIN ST, SUITE 2, PLYMOUTH, MI 48170-2093
(734) 455-4668
(734) 455-4668
Mailing address
13648 CANTERBURY DR, STERLING HEIGHTS, MI 48312-3310
(586) 202-2383
(586) 795-3863

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011643
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
650H231180
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/04/2006
Last updated
06/17/2008
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