MICHELLE NICOLE LASTRA

RIVERVIEW, FL
NPI1275009631
Former NameMICHELLE NICOLE HINSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: FL  9111768)
Enumeration Date2018-10-23
Last Update Date2022-11-03
Business Address
MICHELLE NICOLE LASTRA PA-C
13134 EARLY RUN LN
RIVERVIEW, FL 33578-3387
Phone number: 813-481-8969
Mailing Address
MICHELLE NICOLE LASTRA PA-C
13134 EARLY RUN LN
RIVERVIEW, FL 33578-3387
Phone number: