Individual
JONDARIUS LAMAR RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1510 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-1976
(407) 919-5147
Mailing address
4900 CYPRESS GARDENS RD APT 96, WINTER HAVEN, FL 33884-3905
(407) 919-5147
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5243692
FL
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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