Individual
MISS MYLDRIDE CELESTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13517 LARANJA ST, CLERMONT, FL 34711-8707
(321) 695-7486
Mailing address
13517 LARANJA ST, CLERMONT, FL 34711-8707
(321) 695-7486
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
FL
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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