Individual
LATOYA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3502 HENDERSON BLVD STE 335, TAMPA, FL 33609-3970
(561) 425-4747
Mailing address
PO BOX 13284, TAMPA, FL 33681-3284
(561) 425-4747
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
F460537807860
FL
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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