Individual
TAMICA DEANDRA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
439 SW MICHIGAN ST, LAKE CITY, FL 32025-0440
(386) 487-0800
Mailing address
PO BOX 344, GLEN ST MARY, FL 32040-0344
(904) 408-9062
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
105795
FL
Other
Enumeration date
08/12/2018
Last updated
10/14/2019
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