Individual
JESSICA SUE KOONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-5600
Mailing address
9808 MONTCLAIR CIR, APOPKA, FL 32703-1966
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN9226923
FL
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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