Individual
LAURIVETTE AGOSTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
756 W PALM DR, FLORIDA CITY, FL 33034-3224
(305) 246-3530
(305) 246-4585
Mailing address
756 W PALM DR, FLORIDA CITY, FL 33034-3224
(305) 246-3530
(305) 246-4585
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590839562
—
FL
Enumeration date
01/10/2018
Last updated
01/10/2018
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