Individual
KINISHA E FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11532 HUGGINS ST, LEESBURG, FL 34788-4418
(352) 702-2087
Mailing address
PO BOX 895183, LEESBURG, FL 34789-5183
(352) 702-2087
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
77004
FL
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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