Provider Demographics
NPI:1427391051
Name:DELAESPRIELLA, CLEMENCIA (RRT)
Entity Type:Individual
Prefix:
First Name:CLEMENCIA
Middle Name:
Last Name:DELAESPRIELLA
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31178 CORTEZ BLVD STE 142
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34602-7552
Mailing Address - Country:US
Mailing Address - Phone:813-334-6137
Mailing Address - Fax:855-485-5236
Practice Address - Street 1:31178 CORTEZ BLVD STE 142
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34602-7552
Practice Address - Country:US
Practice Address - Phone:813-334-6137
Practice Address - Fax:855-485-5236
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT73592279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care