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RICHARD LEE COLONEL

>> Driver >> Other Service Providers

Registrant NPI Number: 1033589429

Individual Registrant:
 RICHARD LEE COLONEL 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
143 MELROSE LANDING DR  HAWTHORNE, FL 32640-4417 US
Tel: 352-642-5085  Fax: 877-481-8035

Contact information for business:
PO BOX 571  HAWTHORNE, FL 32640-0571 US
Tel: 352-642-5085  Fax: 877-481-8035

Registration Information:
NPI: 1033589429
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172A00000XOther Service Providers
Driver
FLC454752523700

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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