Individual
DIWANNA P LAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20400 NW 24TH AVE, MIAMI GARDENS, FL 33056-1530
(786) 317-0220
Mailing address
20400 NW 24TH AVE, MIAMI GARDENS, FL 33056-1530
(786) 317-0220
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
FL
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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