Individual
MIRTHA ROSA DE JESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2353 OCOEE APOPKA RD, OCOEE, FL 34761-5301
(407) 573-0228
Mailing address
2353 OCOEE APOPKA RD, OCOEE, FL 34761-5301
(407) 573-0228
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT66870
FL
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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