Individual
MA. DE JESUS BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11722 LYNN BROOK CIR, SEFFNER, FL 33584-7203
(813) 484-2314
(813) 433-5163
Mailing address
11722 LYNN BROOK CIR, SEFFNER, FL 33584-7203
(813) 484-2314
(813) 433-5163
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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