Individual
LE'SHAUN DENINE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
362 17TH STREET, VERO BEACH, FL 32960-0660
(772) 453-4450
Mailing address
1036 CHEVAL DR, VERO BEACH, FL 32960-7073
(772) 453-4450
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA59285
FL
Other
Enumeration date
07/13/2010
Last updated
11/29/2011
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