Individual
DANIELLE C PRODROMIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
403 ANASTASIA BLVD., ST. AUGUSTINE, FL 32080
(904) 825-0569
Mailing address
403 ANASTASIA BLVD., ST. AUGUSTINE, FL 32080
(904) 825-0569
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA47767
FL
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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