Individual
KELVIN YATON GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23134 NW 5TH PL, NEWBERRY, FL 32669-3553
(813) 777-5092
Mailing address
23134 NW 5TH PL, NEWBERRY, FL 32669-3553
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
171244666
FL
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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