Individual
JAVONTE FREDERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
535 ONE CENTER BLVD APT 208, ALTAMONTE SPRINGS, FL 32701-2240
(321) 202-1749
Mailing address
535 ONE CENTER BLVD APT 208, ALTAMONTE SPRINGS, FL 32701-2240
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PTA30943
FL
Other
Enumeration date
03/28/2021
Last updated
03/28/2021
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