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Individual

PAMELA LUTREA DENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
956 NW 206TH TER, MIAMI GARDENS, FL 33169-2387
(786) 306-6514
(305) 749-6623
Mailing address
956 NW 206TH TER, MIAMI GARDENS, FL 33169-2387
(786) 306-6514
(305) 749-6623

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
232790
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232790
AHCA REGISTRATION
FL
Enumeration date
08/07/2012
Last updated
08/07/2012
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