Individual
GUADALUPE LIZETH POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1416 N DONNELLY ST, MOUNT DORA, FL 32757-2814
(407) 476-7497
Mailing address
13217 LAKE YALE VIEW LOOP, GRAND ISLAND, FL 32735-8967
(323) 449-2518
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
99859
FL
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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