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1689456386
MARY DACOSTA
TAVARES, FL
NPI
1689456386
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL APRN11026020)
Enumeration Date
2023-10-17
Last Update Date
2023-10-17
Business Address
MARY DACOSTA FNP-C
1000 WATERMAN WAY
TAVARES, FL 32778-5266
Phone number: 407-456-3948
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Mailing Address
MARY DACOSTA FNP-C
PO BOX 917361
LONGWOOD, FL 32791-7361
Phone number:
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