Individual
JENNIFER CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 SW 7TH AVE, DANIA, FL 33004-3215
(954) 303-6496
Mailing address
PO BOX 1528, DANIA, FL 33004-1528
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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