Individual
DEBREA S BOSTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 EDGE CT, GROVELAND, FL 34736-2520
(352) 973-0693
Mailing address
109 EDGE CT, GROVELAND, FL 34736-2520
(352) 973-0693
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
246RP1900X
Phlebotomy Technician
—
—
261Q00000X
Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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