Individual
MARIE POLYDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4504 CRIMSON CT, ORLANDO, FL 32808-2202
(407) 413-4337
Mailing address
4504 CRIMSON CT, ORLANDO, FL 32808-2202
(407) 413-4337
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
845281
—
FL
Enumeration date
08/02/2021
Last updated
09/24/2021
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