Individual
MS. MICHELE M GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
3450 KAISER AVE, SAINT CLOUD, FL 34772-7311
(407) 301-8804
Mailing address
4701 OLD CANOE CREEK RD UNIT 702121, SAINT CLOUD, FL 34770-7086
(407) 301-8804
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
6969062
FL
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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