Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | ARNP9183248 | FL |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP9183248 | FL |
NPI | 1073578142 |
---|---|
Provider Name | Donita Brezovar |
First Address | Brandon, FL 33510-4538 |
Second Address | Brandon, FL 33511-5779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/07/2007 |