Individual
KENISHA OTARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2343 SW MOUNTWELL ST, PORT SAINT LUCIE, FL 34984-5055
(728) 500-9585
Mailing address
2343 SW MOUNTWELL ST, PORT SAINT LUCIE, FL 34984-5055
(728) 500-9585
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
W790355
FL
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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