Individual
JACQUELINE DORVELUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5131 BLUE WILLOW WAY, PALMETTO, FL 34221-2765
(941) 536-3151
Mailing address
5131 BLUE WILLOW WAY, PALMETTO, FL 34221-2765
(941) 536-3151
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6907119
FL
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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