Individual
BETTY JUSTINE VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2109 ALLSPICE AVE, ORLANDO, FL 32837-9514
(407) 558-4384
Mailing address
2109 ALLSPICE AVE, ORLANDO, FL 32837-9514
(407) 558-4384
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5231792
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
731640
—
FL
Enumeration date
11/26/2018
Last updated
11/26/2018
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