Individual
ANGELICA INEZ JUSINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
514 HILLCREST ST APT B, ORLANDO, FL 32803-4505
(407) 748-0478
Mailing address
514 HILLCREST ST APT B, ORLANDO, FL 32803-4505
(407) 748-0478
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA79728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J250009946640
DRIVERS LICENSE
FL
Enumeration date
10/05/2020
Last updated
10/05/2020
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