Individual
CELESTINE CLIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1153 10TH ST, SUITE A, CLERMONT, FL 34711-2872
(352) 255-6458
(352) 410-6118
Mailing address
1330 RAINTREE BND, APT. 108, CLERMONT, FL 34714-8476
(352) 255-6458
(352) 410-6118
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C416100648050
DRIVERS LICENSE
FL
Enumeration date
10/12/2012
Last updated
10/12/2012
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