Organization
JUSTITIA HADDAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTITIA HADDAD (COTA)
(941) 962-3312
Entity
Organization
Contact information
Practice address
4312 55TH AVE DRIVE EAST, BRADENTON, FL 34203
(941) 962-3312
Mailing address
4312 55TH AVE DRIVE EAST, BRADENTON, FL 34203
(941) 962-3312
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTA 10758
FL
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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