Individual
MS. DESIREE DISMUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 W CHURCH AVE, LONGWOOD, FL 32750-4105
(407) 342-4220
Mailing address
1883 POMEGRANATE CT, OCOEE, FL 34761-7699
(407) 600-7424
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/06/2017
Last updated
06/06/2019
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