Individual
MASSIEL REYNALDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 W BALLAST POINT BLVD, TAMPA, FL 33611-5601
(813) 775-8689
Mailing address
4401 W BALLAST POINT BLVD, TAMPA, FL 33611-5601
(813) 775-8689
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12485
FL
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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