Individual
JESSE ALBATROSOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 S PALMETTO AVE, DAYTONA BEACH, FL 32114-4387
(386) 562-8213
Mailing address
119 S PALMETTO AVE, DAYTONA BEACH, FL 32114-4387
(386) 562-8213
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
ALPP-29291
FL
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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