Individual
LAVONIA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10381 SW 226TH ST, CUTLER BAY, FL 33190-1464
(216) 326-9412
Mailing address
10381 SW 226TH ST, CUTLER BAY, FL 33190-1464
(216) 326-9412
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11027969
FL
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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