Individual
EL FADL DAISSAOUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1255 GOLFVIEW AVE, BARTOW, FL 33830-6736
(863) 519-0575
(863) 582-9251
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 582-9251
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9380858
FL
Other
Enumeration date
12/22/2021
Last updated
12/22/2021
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