Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN11007834 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | APRN11007834 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN11007834 | FL |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN11007834 | FL |
NPI | 1073130688 |
---|---|
Provider Name | Iris Nereida Bosse |
First Address | Orlando, FL 32862-8485 |
Second Address | Orlando, FL 32862-8485 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2020 |
Last Update Date | 18/01/2021 |