Individual
MARY FULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
601 E ROLLINS ST STE 400, ORLANDO, FL 32803-1248
(407) 303-9507
Mailing address
207 OVERSTREET AVE, LONGWOOD, FL 32750-5428
(407) 421-1470
(321) 295-7678
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
927-0573
FL
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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