Individual
MRS. ETHEL HARRIET STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12365 152ND ST N, JUPITER, FL 33478-3558
(561) 222-6503
Mailing address
12365 152ND ST N, JUPITER, FL 33478-3558
(561) 222-6503
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23928849
—
FL
Enumeration date
03/09/2009
Last updated
03/09/2009
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