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Individual

BRENDA L LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
95024 RAINTREE LN, FERNANDINA, FL 32034-7105
(904) 557-8002
(904) 432-8115
Mailing address
95024 RAINTREE LN, FERNANDINA, FL 32034-7105
(904) 557-8002
(904) 432-8115

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
FL
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100069124
FL
Enumeration date
04/20/2018
Last updated
04/20/2018
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