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1699145672
WILSON FONSECA
KISSIMMEE, FL
NPI
1699145672
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: FL 163w0000x)
Enumeration Date
2015-10-02
Last Update Date
2015-10-02
Business Address
-- WILSON FONSECA
4129 BALD EAGLE DR
KISSIMMEE, FL 34746-2901
Phone number: 786-447-4100
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Mailing Address
-- WILSON FONSECA
4129 BALD EAGLE DR
KISSIMMEE, FL 34746-2901
Phone number: 786-447-4100
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