Provider Information for 1346603768
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CINDY DIETRICH
Other Names:Former Name:CINDY LEMUSSex: Female
NPI: 1346603768
Last Updated: 2016-04-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1346603768 | ||||||||
| Enumeration Date | 2016-04-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 319 ERIE DR KISSIMMEE, FL 34759-5342 United States Phone: 718-216-1424 | Fax: | ||||||||
| Primary Practice Address | 319 ERIE DR KISSIMMEE, FL 34759-5342 United States Phone: 718-216-1424 | Fax: | ||||||||
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