Individual
SARA LISA NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 WHITEHALL WAY, KISSIMMEE, FL 34758-4114
(718) 415-6353
Mailing address
113 WHITEHALL WAY, KISSIMMEE, FL 34758-4114
(718) 415-6353
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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