| NPI | 1447744768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX M PULIDO Owner 386-329-9036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: FL 9471740) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9471740) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 9471740) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9471740) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |