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Individual

ISADORA DANIA EVORA-POLANCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
358 WILLOWBAY RIDGE ST, SANFORD, FL 32771-6740
(646) 228-3621
Mailing address
358 WILLOWBAY RIDGE ST, SANFORD, FL 32771-6740
(646) 228-3621

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
222Q00000X
PRIMARY TAXONOMY
FL
Enumeration date
07/22/2022
Last updated
07/22/2022
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