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Individual

MRS. CARROLL LOLITA GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1119 SAND CREEK LOOP, OCOEE, FL 34761
(407) 346-9498
Mailing address
PO BOX 617045, ORLANDO, FL 32861
(407) 346-9498

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
FL

Other

Enumeration date
10/14/2020
Last updated
10/14/2020
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