| NPI | 1265087993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTA JAYLEEN KOVACHEVICH Owner/Ap RN Cpnp Pc 321-313-3595 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |