Individual
MAKENSON GEFFRARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4118 SW UTTERBACK ST, PORT SAINT LUCIE, FL 34953-6100
(772) 607-0492
Mailing address
4118 SW UTTERBACK ST, PORT SAINT LUCIE, FL 34953-6100
(772) 607-0492
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11020573
FL
Other
Enumeration date
07/03/2022
Last updated
07/03/2022
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