Individual
HERMINA JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3502 LONDONBERRY BLVD, ORLANDO, FL 32808-3629
(407) 334-5475
Mailing address
3502 LONDONDERRY BLVD, ORLANDO, FL 32808-3629
(407) 334-5475
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AHCA # 6906583
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008297100
—
FL
Enumeration date
09/16/2014
Last updated
09/16/2014
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