Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1519592 | FL |
NPI | 1275619850 |
---|---|
Provider Name | Mrs. Deborah Carter Fulop |
First Address | Jacksonville, FL 32225-4862 |
Second Address | Jacksonville, FL 32216-1471 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |