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Individual

GLORIA A VINES-WILKINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1636 FISKE BLVD, ROCKLEDGE, FL 32955-2535
(321) 634-6047
(321) 634-6527
Mailing address
1636 FISKE BLVD, ROCKLEDGE, FL 32955-2535
(321) 634-6047
(321) 634-6527

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/28/2007
Last updated
07/08/2007
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