Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11008460 | FL |
NPI | 1003413113 |
---|---|
Provider Name | Miss Cristina Lynn Koniver |
First Address | Miami, FL 33136-1101 |
Second Address | Miami, FL 33136-1101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2020 |
Last Update Date | 02/10/2020 |