Individual
GERHONDA WANISE PLAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2935 HOLLY POINT DR, JACKSONVILLE, FL 32277-3508
(904) 651-1177
Mailing address
2935 HOLLY POINT DR, JACKSONVILLE, FL 32277-3508
(904) 651-1177
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002327300
—
FL
Enumeration date
01/02/2020
Last updated
01/23/2023
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