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Individual

MARY JO LAWRENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNMT, RT, RS

Contact information

Practice address
2489 DIPLOMAT PKWY E, CAPE CORAL, FL 33909-5422
(239) 652-1800
Mailing address
2489 DIPLOMAT PKWY E, CAPE CORAL, FL 33909-5422
(239) 652-1800

Taxonomy

Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
14605
FL
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
Primary
CRT51441
FL

Other

Enumeration date
03/05/2021
Last updated
03/05/2021
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