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ORVILLE A MIRACLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
1100 S OLYMPIA ST, CLEWISTON, FL 33440-4400
(863) 983-1408
Mailing address
1100 S OLYMPIA ST, CLEWISTON, FL 33440-4400
(863) 983-1408

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2158942
FL

Other

Enumeration date
04/03/2013
Last updated
04/03/2013
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