Individual
CRYSTAL EVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2132 68TH TER S, ST PETERSBURG, FL 33712
(727) 648-8410
Mailing address
2132 68TH TER S, ST PETERSBURG, FL 33712-5821
(727) 648-8410
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/10/2013
Last updated
12/10/2013
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