Individual
CANDICE RENE GINGLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17470 BROOKSIDE TRACE CT, TAMPA, FL 33647-6201
(813) 600-5994
Mailing address
7499 OAK ST NE, ST PETERSBURG, FL 33702-5443
(407) 927-4901
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17253
FL
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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