Individual
CHRISTY ELIZABETH HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10397 BRADMORE RD, FORT MYERS, FL 33913-9730
(239) 201-0627
Mailing address
10397 BRADMORE RD, FORT MYERS, FL 33913-9730
(239) 201-0627
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
317468
FL
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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