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Individual

MRS. DANYETTA TAVARES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OWNER

Contact information

Practice address
1607 PICCADILLY DR, DAYTONA BEACH, FL 32117-3829
(407) 242-0210
Mailing address
1433 FONTAINE DR, APOPKA, FL 32703-7337
(407) 242-0210

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
FL

Other

Enumeration date
06/11/2015
Last updated
06/11/2015
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