Individual
FONDA FORWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
5418 NW 20TH CT, APT B, GAINESVILLE, FL 32653-8120
(352) 215-0475
Mailing address
5418 NW 20TH CT, APT B, GAINESVILLE, FL 32653-8120
(352) 215-0475
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
260658
FL
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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