Individual
JUANA LETICIA GASPAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14824 SW OKEECHOBEE DR, INDIANTOWN, FL 34956-3238
(772) 643-1279
Mailing address
PO BOX 1862, INDIANTOWN, FL 34956-1862
(772) 643-1279
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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