Individual
YAMELYS PONS DURAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20197 NAVAJO LN, PORT CHARLOTTE, FL 33952-4047
(941) 735-8404
Mailing address
20197 NAVAJO LN, PORT CHARLOTTE, FL 33952-4047
(941) 735-8404
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205281151
—
FL
Enumeration date
04/28/2016
Last updated
01/10/2017
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