Individual
CHRISTELLA DORVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1258 SW ERMINE AVE, PORT ST LUCIE, FL 34953-5006
(772) 207-7947
Mailing address
1258 SW ERMINE AVE, PORT ST LUCIE, FL 34953-5006
(772) 207-7947
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906705
FL
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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