Individual
CALISTA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
(863) 280-6085
Mailing address
200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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