Individual
QUINTON WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5519 MYRTICE LN, LAKELAND, FL 33810-3200
(863) 409-1135
Mailing address
5519 MYRTICE LN, LAKELAND, FL 33810-3200
(863) 409-1135
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
129611400
FL
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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