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1083136808
VENECIA LASALLE JEAN
MIAMI, FL
NPI
1083136808
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Other Name
VENECIA LASALLE JEAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
Enumeration Date
2017-07-13
Last Update Date
2017-07-13
Business Address
VENECIA LASALLE JEAN
6304 NW 14TH AVE
MIAMI, FL 33147-8008
Phone number: 908-368-1156
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Mailing Address
VENECIA LASALLE JEAN
435 NE 171ST TER
NORTH MIAMI BEACH, FL 33162-3914
Phone number: 908-368-1156
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