Individual
JAHVONTAE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4316 MARINERS COVE CT APT 104, TAMPA, FL 33610-9014
(352) 364-6422
Mailing address
4316 MARINERS COVE CT APT 104, TAMPA, FL 33610-9014
(352) 364-6422
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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