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Individual

CHERYL DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
919 COMMODORE ST, LEHIGH ACRES, FL 33974-4550
(239) 303-4637
(239) 244-9306
Mailing address
919 COMMODORE ST, LEHIGH ACRES, FL 33974-4550
(239) 303-4637
(239) 244-9306

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906497
FL

Other

Enumeration date
08/01/2012
Last updated
08/01/2012
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