Individual
DATONYA BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4649 COLCHESTER RD, JACKSONVILLE, FL 32208-1110
(352) 239-7179
Mailing address
4649 COLCHESTER RD, JACKSONVILLE, FL 32208-1110
(352) 239-7179
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
251S00000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01811700
—
FL
Enumeration date
04/14/2017
Last updated
04/14/2017
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