Individual
BEANCA LOTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3077 TOWER OAKS DR, ORANGE PARK, FL 32065-2546
(904) 405-0892
Mailing address
3077 TOWER OAKS DR, ORANGE PARK, FL 32065-2546
(904) 405-0892
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5242369
FL
Other
Enumeration date
11/24/2019
Last updated
11/24/2019
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