Individual
KEIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1081 BRADFORD RIDGE DR, LEESBURG, FL 34748-9209
(352) 217-3080
Mailing address
1081 BRADFORD RIDGE DR, LEESBURG, FL 34748-9209
(352) 217-3080
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
FL
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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