Individual
VERONICA DEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N., C.L.C.
Contact information
Practice address
3576 SHAMROCK DR, VENICE, FL 34293-2928
(941) 451-7684
Mailing address
3576 SHAMROCK DR, VENICE, FL 34293-2928
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN 5202780
FL
174N00000X
Lactation Consultant (Non-RN)
Primary
ALPP-238443
FL
Other
Enumeration date
02/22/2017
Last updated
02/23/2017
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