Individual
JULIANNE EASTMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4504 LEE BLVD, LEHIGH ACRES, FL 33971-1627
(239) 798-8764
Mailing address
4504 LEE BLVD, LEHIGH ACRES, FL 33971-1627
(239) 798-8764
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906763
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015293000
—
FL
01
—
6906763
AHCA
FL
Enumeration date
11/17/2015
Last updated
11/17/2015
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