Individual
MISS STEFANIA MORILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
516 SE WALTON LAKES DR, PORT ST LUCIE, FL 34952-3488
(772) 323-7163
Mailing address
516 SE WALTON LAKES DR, PORT ST LUCIE, FL 34952-3488
(772) 323-7163
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA58636
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA58636
FLORIDA LICENSE
FL
Enumeration date
04/07/2011
Last updated
04/07/2011
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