Individual
TAKERIA JALEESA BORDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
1035 W TEE CIR, BARTOW, FL 33830-6140
(813) 494-2635
Mailing address
1035 W TEE CIR, BARTOW, FL 33830-6140
(813) 494-2635
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-122
WI
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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