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Individual

ANNIE FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
4421 POWDERHORN PLACE DR, CLERMONT, FL 34711-8926
(407) 705-7587
Mailing address
4421 POWDERHORN PLACE DR, CLERMONT, FL 34711-8926
(407) 705-7587

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9115846
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9115846
PHYSICIAN ASSISTANT LICENSE NUMBER
Enumeration date
06/08/2022
Last updated
06/08/2022
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