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Individual

MARIO CLAVIJO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
801 DOUGLAS AVE, ALTAMONTE SPRINGS, FL 32714-5206
(407) 830-6412
Mailing address
801 DOUGLAS AVE, ALTAMONTE SPRINGS, FL 32714-5206

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
08/26/2014
Last updated
04/16/2017
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