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1669169918
RICHARD LONGSTREET
TAMPA, FL
NPI
1669169918
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QD1600X Clinic/Center, Developmental Disabilities
Enumeration Date
2023-04-18
Last Update Date
2023-04-18
Business Address
RICHARD LONGSTREET
7369 BONITA VISTA WAY APT 202
TAMPA, FL 33617-8697
Phone number: 813-765-4080
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Mailing Address
RICHARD LONGSTREET
7369 BONITA VISTA WAY APT 202
TAMPA, FL 33617-8697
Phone number: 813-765-4080
Copy
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