Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 11003576 | FL |
NPI | 1215582481 |
---|---|
Provider Name | Dr. Julia Nogueira Peredo |
First Address | Jacksonville, FL 32209-6511 |
Second Address | Jacksonville, FL 32209-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2019 |
Last Update Date | 05/08/2019 |