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1154953008
DEMETRIC GAZZARA ELLIS
JACKSONVILLE, FL
NPI
1154953008
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
253Z00000X In Home Supportive Care
(Licence: FL 30402)
Enumeration Date
2020-02-09
Last Update Date
2020-02-09
Business Address
DEMETRIC GAZZARA ELLIS
1600 LANSDOWNE DR APT 215
JACKSONVILLE, FL 32211-5151
Phone number: 904-444-0180
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Mailing Address
DEMETRIC GAZZARA ELLIS
1600 LANSDOWNE DR APT 215
JACKSONVILLE, FL 32211-5151
Phone number: 904-444-0180
Copy
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