Individual
DEMETRIUS ANTWAN HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 TARAWA ST, LAKELAND, FL 33805-2950
(646) 717-7222
Mailing address
203 TARAWA ST, LAKELAND, FL 33805-2950
(646) 717-7222
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
FL
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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