Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | ARNP2966222 | FL |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP2966222 | FL |
NPI | 1144778788 |
---|---|
Provider Name | Mrs. Colleen Scolari |
First Address | Melbourne, FL 32901-3224 |
Second Address | Melbourne, FL 32901-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2016 |
Last Update Date | 12/09/2016 |