Individual
LISA MARIE DIBENEDETTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1 UNF DRIVE, JACKSONVILLE, FL 32224
(904) 620-5135
Mailing address
1 UNF DRIVE, JACKSONVILLE, FL 32224
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3305
FL
Other
Enumeration date
05/22/2015
Last updated
05/22/2015
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