Individual
ILIANA STENIE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 SE WHITMORE DR, PORT ST LUCIE, FL 34984-4560
(772) 785-7110
(772) 785-7110
Mailing address
508 SE WHITMORE DR, PORT ST LUCIE, FL 34984-4560
(772) 785-7110
(772) 785-7110
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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