Individual
MADELLA NONE BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3800 SW 2ND CT APT 2, FORT LAUDERDALE, FL 33312-1891
(305) 525-2147
Mailing address
3800 SW 2ND CT APT 2, FORT LAUDERDALE, FL 33312-1891
(305) 525-2147
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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