Individual
FAEDRA GREENIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
199 KASSIK CIR, ORLANDO, FL 32824-5831
(321) 800-6512
Mailing address
199 KASSIK CIR, ORLANDO, FL 32824-5831
(321) 800-6512
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/11/2015
Last updated
11/11/2015
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