Individual
MS. LOURDES IRINA COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3423 SE BEVIL AVE, PORT ST LUCIE, FL 34984-6539
(772) 579-7077
Mailing address
3423 SE BEVIL AVE, PORT ST LUCIE, FL 34984-6539
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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