Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9274858 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | ARNP9274858 | FL |
NPI | 1063912848 |
---|---|
Provider Name | Mr. Michael Shannon Diprimo |
First Address | Ocala, FL 34480-4913 |
Second Address | Ocala, FL 34474-7435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2018 |
Last Update Date | 18/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ARNP9274858 | STATE (01) | FL |