Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN9302815 | FL |
NPI | 1003274473 |
---|---|
Provider Name | Carly Delbert Fioramanti |
First Address | Lake Placid, FL 33852-6978 |
Second Address | Lake Placid, FL 33852-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2016 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016664500 | (05) | FL |
DQEAD | BLUE CROSS BLUE SHIELD (01) | FL |