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Individual

KRISTA SPEECE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2622 DIPLOMAT DR, MELBOURNE, FL 32901-6804
(321) 745-9727
Mailing address
2622 DIPLOMAT DR, MELBOURNE, FL 32901-6804
(321) 745-9727

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022122700
FL
Enumeration date
01/29/2019
Last updated
01/29/2019
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