Individual
EDOUARD ST HILAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
298 SW CARTER AVE, PORT ST LUCIE, FL 34983-3064
(772) 301-1132
Mailing address
298 SW CARTER AVE, PORT ST LUCIE, FL 34983-3064
(772) 301-1132
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906864
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018422200
—
FL
Enumeration date
11/04/2016
Last updated
11/04/2016
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