ANTAVIAN EDISON

FORT MYERS, FL
NPI1063074292
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
Enumeration Date2019-07-09
Last Update Date2019-07-09
Business Address
ANTAVIAN EDISON
2789 ORTIZ AVE
FORT MYERS, FL 33905-7806
Phone number: 239-275-3222
Mailing Address
ANTAVIAN EDISON
3763 EVANS AVE
FORT MYERS, FL 33901-9302
Phone number: 239-275-3222