Individual
LOURDES PATRICIA CAMPO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1348 WESTWINDS DR, DAVENPORT, FL 33837-3846
(321) 274-2033
Mailing address
1348 WESTWINDS DR, DAVENPORT, FL 33837-3846
(321) 274-2033
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C516535919710
FL
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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