Individual
KEISHLA DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8285 46TH AVE, VERO BEACH, FL 32967-5689
(772) 257-1346
Mailing address
8285 46TH AVE, VERO BEACH, FL 32967-5689
(772) 257-1346
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
27000
PR
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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