Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9199808 | FL |
NPI | 1033409487 |
---|---|
Provider Name | Karen Mingo |
First Address | Orlando, FL 32806-2002 |
Second Address | Orlando, FL 32806-2002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2011 |
Last Update Date | 19/04/2011 |