Individual
JANICE CARRASQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 N ROSE AVE, KISSIMMEE, FL 34741-4944
(407) 343-6111
Mailing address
810 N ROSE AVE, KISSIMMEE, FL 34741-4944
(407) 343-6111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA53421
FL
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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