Individual
MICHELET CAZEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ADMINISTRATOR
Contact information
Practice address
724 CHINA BERRY CIR, DAVENPORT, FL 33837-3908
(908) 463-9079
(863) 837-4410
Mailing address
724 CHINA BERRY CIR, DAVENPORT, FL 33837-3908
(908) 463-9079
(863) 837-4410
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906977
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103536700
—
FL
Enumeration date
06/11/2019
Last updated
11/25/2019
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