Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9269375 | FL |
NPI | 1003120700 |
---|---|
Provider Name | Mrs. Ellen G Tindal |
First Address | Orlando, FL 32806-1101 |
Second Address | Orlando, FL 32806-1101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2010 |
Last Update Date | 23/10/2014 |