Individual
LILYETH ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 6TH AVE N APT E, JACKSONVILLE BEACH, FL 32250-5749
(786) 554-3129
Mailing address
330 6TH AVE N APT E, JACKSONVILLE BEACH, FL 32250-5749
(786) 554-3129
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/11/2017
Last updated
10/11/2017
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