Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9301923 | FL |
NPI | 1003342270 |
---|---|
Provider Name | Miss Sadaf Nazar Malik |
First Address | Gainesville, FL 32608-1516 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2017 |
Last Update Date | 28/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020886600 | (05) | FL |
IZ062Z | MEDICARE PTAN (01) |