Individual
MR. JEAN RUBENS DANTILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 NW TWYLITE TER, PORT ST LUCIE, FL 34983-1144
(772) 979-0288
(772) 871-9270
Mailing address
555 NW TWYLITE TER, PORT ST LUCIE, FL 34983-1144
(772) 871-9270
(772) 460-8050
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
104100000X
Social Worker
—
—
Other
Enumeration date
12/05/2006
Last updated
07/09/2007
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