Individual
TRISHANA SAMANTHA QUALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6801 LAKE WORTH RD, 307, GREENACRES, FL 33467-2955
(561) 487-0553
Mailing address
1743 N CONGRESS AVE, WEST PALM BEACH, FL 33401-1664
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9450285
FL
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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