Individual
DAISY COREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 W VINE ST, 268, KISSIMMEE, FL 34741-4643
(863) 242-8844
Mailing address
3501 W VINE ST, 268, KISSIMMEE, FL 34741-4643
(863) 242-8844
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
648586
—
FL
Enumeration date
03/17/2017
Last updated
03/17/2017
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