Organization
MATRIX 5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN SOLEY (OWNER)
(352) 549-7177
Entity
Organization
Contact information
Practice address
2629 ROWAN ST, TAVARES, FL 32778-2083
(407) 906-8277
Mailing address
2629 ROWAN ST, TAVARES, FL 32778-2083
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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