Individual
MISS NINA LYNN COLETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
13837 CIRCA CROSSING DR, LITHIA, FL 33547-4382
(813) 684-2663
Mailing address
19628 45TH AVE, FLUSHING, NY 11358-3508
(718) 791-2911
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6375
FL
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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