Individual
MARY BETH ULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1755 N. FLORIDA AVENUE, BELLA VISTA BLDG., LAKELAND, FL 33805-3109
(863) 904-6200
Mailing address
PO BOX 95004, LAKELAND, FL 33804-5004
(863) 680-7206
(866) 264-8519
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
#119593
FL
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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