Individual
ROSEMITA PETION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
757 SW DUVAL AVE, PORT ST LUCIE, FL 34983-2438
(772) 807-8688
Mailing address
757 SW DUVAL AVE, PORT ST LUCIE, FL 34983-2438
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA30784
FL
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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