Individual
MR. REGINALD BERNARD MIMS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 OAKLAND AVE, SANFORD, FL 32773-6237
(407) 625-1995
Mailing address
105 OAKLAND AVE, SANFORD, FL 32773-6237
(407) 625-1995
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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