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Individual

GENEVA DRIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3031 NE 14TH ST, GAINESVILLE, FL 32609-3122
(352) 658-5085
Mailing address
3031 NE 14TH ST, GAINESVILLE, FL 32609-3122
(352) 658-5085

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
234674
FL

Other

Enumeration date
04/20/2018
Last updated
04/20/2018
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