Individual
SHANNA NICOLE QUICENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9689 N BELFORT CIR, TAMARAC, FL 33321-1887
(954) 850-3351
Mailing address
9689 N BELFORT CIR, TAMARAC, FL 33321-1887
(954) 850-3351
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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