Individual
MARIO R TELFAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 SHAD WAY, POINCIANA, FL 34759-4730
(727) 492-3685
Mailing address
301 SHAD WAY, POINCIANA, FL 34759-4730
(727) 492-3685
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6907018
FL
Other
Enumeration date
05/29/2020
Last updated
06/01/2020
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