Individual
JESUS PRIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
939 PARK MANOR DR, ORLANDO, FL 32825-6744
(407) 432-6785
(407) 897-7452
Mailing address
939 PARK MANOR DR, ORLANDO, FL 32825-6744
(407) 432-6785
(407) 897-7452
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
AL12312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008511900
—
FL
Enumeration date
08/07/2015
Last updated
08/07/2015
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