Individual
MISS LESA ROMONA SEALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 MADRE DE DIOS ST, PUNTA GORDA, FL 33983-4254
(941) 629-4934
(941) 629-4934
Mailing address
15 MADRE DE DIOS ST, PUNTA GORDA, FL 33983-4254
(941) 629-4934
(941) 629-4934
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906321
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001064300
—
FL
Enumeration date
05/09/2013
Last updated
05/09/2013
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