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Individual

SUPRINA MICHELLE GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5439 WEBER PL, LAKELAND, FL 33809-4271
(813) 967-9850
Mailing address
5439 WEBER PL, LAKELAND, FL 33809-4271
(813) 967-9850

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
04/03/2026
Last updated
04/03/2026
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