Individual
MS. DELORIS MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
385 W LAKE RD, MONTICELLO, FL 32344-5647
(850) 997-0141
(850) 997-1208
Mailing address
385 W LAKE RD, MONTICELLO, FL 32344-5647
(850) 997-0141
(850) 997-1208
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA19247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141346500
—
FL
Enumeration date
08/13/2013
Last updated
08/13/2013
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