Individual
JESSIE AMEDO PERLADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
454 LAKE HARRIS DR, LAKELAND, FL 33813-2689
(863) 393-7222
Mailing address
454 LAKE HARRIS DR, LAKELAND, FL 33813-2689
(863) 393-7222
(863) 583-0878
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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