Individual
STACY AGYARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11552 WESTON COURSE LOOP, RIVERVIEW, FL 33579-4032
(703) 878-7601
Mailing address
11552 WESTON COURSE LOOP, RIVERVIEW, FL 33579-4032
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
SU51076
FL
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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