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1285211847
JAVONTE FREDERICKS
ALTAMONTE SPRINGS, FL
NPI
1285211847
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine
(Licence: FL pta30943)
Enumeration Date
2021-03-28
Last Update Date
2021-03-28
Business Address
JAVONTE FREDERICKS
535 ONE CENTER BLVD APT 208
ALTAMONTE SPRINGS, FL 32701-2240
Phone number: 321-202-1749
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Mailing Address
JAVONTE FREDERICKS
535 ONE CENTER BLVD APT 208
ALTAMONTE SPRINGS, FL 32701-2240
Phone number:
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