Individual
ILA ANITA MORIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3100 17TH ST, SAINT CLOUD, FL 34769-6021
(407) 892-0009
(407) 892-3285
Mailing address
2209 SUMMER RAYE CT, SAINT CLOUD, FL 34772-8588
(561) 868-3663
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107402
FL
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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