Individual
MRS. MARISOL LYNETTE NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
855 HICKORY AVE, ORANGE CITY, FL 32763-6864
(386) 334-4181
Mailing address
855 HICKORY AVE, ORANGE CITY, FL 32763-6864
(386) 334-4181
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/11/2023
Last updated
11/24/2023
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