Individual
JOANISE METELUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3346 SW MARTIN ST, PORT ST LUCIE, FL 34953-4915
(772) 497-4364
Mailing address
3346 SW MARTIN ST, PORT ST LUCIE, FL 34953-4915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5162565
FL
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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