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1942808977
ETLEVA ILIAZI
JACKSONVILLE, FL
NPI
1942808977
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11003397)
Enumeration Date
2020-10-12
Last Update Date
2020-10-12
Business Address
ETLEVA ILIAZI
13241 BARTRAM PARK BLVD
JACKSONVILLE, FL 32258-5212
Phone number: 904-288-6910
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Mailing Address
ETLEVA ILIAZI
8722 BELLE RIVE BLVD
JACKSONVILLE, FL 32256-8452
Phone number: 904-382-5238
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