Individual
OMAR E DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2479 ALOMA AVE UNIT D, WINTER PARK, FL 32792-2541
(407) 657-6692
(407) 894-6010
Mailing address
4751 WALDEN CIR APT C, ORLANDO, FL 32811-7327
(407) 309-0549
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
D222-645-85-017-0
FL
Other
Enumeration date
12/10/2011
Last updated
12/10/2011
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