Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 11014789 | FL |
NPI | 1003576604 |
---|---|
Provider Name | Brittany Cedarburg |
First Address | Tampa, FL 33612 |
Second Address | Tampa, FL 33612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2021 |
Last Update Date | 22/12/2021 |