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Individual

ILIUD CARRILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3440 56TH AVE NE, NAPLES, FL 34120-7416
(239) 207-7013
Mailing address
3440 56TH AVE NE, NAPLES, FL 34120-7416
(239) 207-7013

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9344179
FL
163WP2201X
Ambulatory Care Registered Nurse
9344179
FL

Other

Enumeration date
11/07/2016
Last updated
11/07/2016
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