Individual
MYRTHA ST VICTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1259 SE NANCY LN, PORT SAINT LUCIE, FL 34983-3119
(772) 359-6787
Mailing address
1259 SE NANCY LN, PORT SAINT LUCIE, FL 34983-3119
(772) 359-6787
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5195617
FL
Other
Enumeration date
10/26/2010
Last updated
12/29/2010
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