Individual
CONSWELLO IBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2126 NICOLLETT WAY, LEESBURG, FL 34748-2958
(352) 530-7705
Mailing address
2126 NICOLLETT WAY, LEESBURG, FL 34748-2958
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
FL
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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