JUAN CARLOS FONTANEZ

KISSIMMEE, FL
NPI1962129395
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2022-10-26
Last Update Date2022-10-27
Business Address
JUAN CARLOS FONTANEZ
2005 GRANDE CT APT 902
KISSIMMEE, FL 34743-3130
Phone number: 939-313-8920
Mailing Address
JUAN CARLOS FONTANEZ
PRESERVERS OF DESTINIES 1621 E. VINE ST
KISSIMMEE, FL 34744
Phone number: