Most Relevant Information
Provider Data
| NPI Number: | 1003388281 |
| Provider Name: | LYSSETTE KELLY CRAIG |
| Entity Type: | Individual |
| Taxonomy Code: | 311ZA0620X |
| Specialty: | Custodial Care Facility |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/27/2018 |
| Last Updated: | 12/27/2018 |
Provider Practice Location
7764 ANDORA DR
SARASOTA
FL
342384753
Practice Location Phone/Fax
| Phone: | 3047032644 |
| Fax: |
Provider Mailing Location
7764 ANDORA DR
SARASOTA
FL
342384753
Provider Mailing Phone/Fax
| Phone: | 3047032644 |
| Fax: |