Individual
MR. DEANDRE CLAUDE FULLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
8841 LYNDALL LN, PALM BEACH GARDENS, FL 33403-1639
(561) 631-9997
Mailing address
16894 73RD CT N # CTN, LOXAHATCHEE, FL 33470-5838
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
855671
FL
Other
Enumeration date
07/30/2022
Last updated
07/30/2022
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