Individual
KETTELIE NAJAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23515 VALDERAMA LN, SORRENTO, FL 32776-6937
(352) 357-1199
Mailing address
23515 VALDERAMA LN, SORRENTO, FL 32776-6937
(352) 357-1199
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
RN9256863
FL
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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