Individual
ELIANNE JEROME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4421 PORPOISE DR, TAMPA, FL 33617-8315
(813) 852-4589
Mailing address
2158 BRANDON PARK CIR, BRANDON, FL 33510-3946
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
12/21/2024
Last updated
12/21/2024
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