Individual
CHRISTINA A DEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18117 DICKENS AVE, PORT CHARLOTTE, FL 33954-1763
(941) 276-4937
Mailing address
18117 DICKENS AVE, PORT CHARLOTTE, FL 33954-1763
(941) 276-4937
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
000523200
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000523200
—
FL
Enumeration date
12/10/2010
Last updated
12/10/2010
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