Individual
CLAUDETTE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4103 DAY BRIDGE PL, ELLENTON, FL 34222-7236
(941) 580-1885
Mailing address
4103 DAY BRIDGE PL, ELLENTON, FL 34222-7236
(941) 580-1885
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
6906993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6906993
ADULT FAMILY CARE HOME LICENSE
FL
Enumeration date
06/13/2019
Last updated
06/13/2019
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