Individual
AISSA BEMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 898-7451
Mailing address
8643 TARRAGON DR, ORLANDO, FL 32825-3644
(727) 742-8085
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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