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Individual

MR. LEO LUNDY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
2632 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-2845
(321) 895-0778
Mailing address
2632 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-2845
(321) 895-0778

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
FL

Other

Enumeration date
04/29/2019
Last updated
04/29/2019
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