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Individual

MRS. ANTOINETTE SHAREE' VAZQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1601 JOHNS LAKE RD APT 435, CLERMONT, FL 34711-6683
(352) 497-8713
Mailing address
1601 JOHNS LAKE RD APT 435, CLERMONT, FL 34711-6683
(352) 497-8713

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
2322332
FL
376J00000X
Homemaker
232332
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003280500
FL
Enumeration date
10/19/2011
Last updated
10/19/2011
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