Individual
HOPE JAMIA SUMMERALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S STATE ST UNIT C, BUNNELL, FL 32110-6191
(407) 885-6517
Mailing address
401 S STATE ST UNIT C, BUNNELL, FL 32110-6191
(407) 885-6517
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C401K5KWZ4
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871124644
—
FL
Enumeration date
08/29/2022
Last updated
07/11/2024
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