Individual
KELLY NICOLE PETION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4271 NW 5TH ST APT 126, PLANTATION, FL 33317-2110
(305) 849-1504
Mailing address
4271 NW 5TH ST APT 126, PLANTATION, FL 33317-2110
(305) 849-1504
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
23901
FL
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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