Individual
ABLA HERZALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 DELTONA BLVD, SAINT AUGUSTINE, FL 32086-7020
(352) 282-2876
Mailing address
55 DELTONA BLVD, SAINT AUGUSTINE, FL 32086-7020
(352) 282-2876
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19713800
—
FL
Enumeration date
08/07/2014
Last updated
08/07/2014
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