Individual
MATESHA FEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
218 SW THIRD AVE, MADISON, FL 32340-1266
(860) 973-5000
Mailing address
218 SW THIRD AVE, MADISON, FL 32340-1266
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5211371
FL
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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