Individual
MRS. NICETAS GAGAN MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9670 134TH ST, SEMINOLE, FL 33776-1447
(727) 596-3266
(727) 754-7670
Mailing address
5275 87TH TER N, PINELLAS PARK, FL 33782-5137
(727) 504-9455
(727) 754-7670
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
8295
FL
Other
Enumeration date
12/30/2018
Last updated
12/30/2018
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