Individual
BIANCA M PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 ATLANTIC AVE, FRUITLAND PARK, FL 34731-3225
(352) 455-1362
Mailing address
1111 ATLANTIC AVE, FRUITLAND PARK, FL 34731-3225
(352) 455-1362
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
AHCA
—
Enumeration date
01/08/2020
Last updated
01/08/2020
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