Individual
TAMMY SUZANNE LIDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
482 S KELLER RD, ORLANDO, FL 32810-6130
(321) 397-3000
Mailing address
482 S KELLER RD, ORLANDO, FL 32810-6130
(321) 397-3000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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