Individual
LAQUANZA M THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2317 W PINE ST, TAMPA, FL 33607-3456
(813) 516-3376
Mailing address
2317 W PINE ST, TAMPA, FL 33607-3456
(813) 516-3376
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
231937
FL
376J00000X
Homemaker
Primary
231937
FL
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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