Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 9213983 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 9213983 | DE |
N | 363LP2300X | Nurse Practitioner - Primary Care | 9213983 | FL |
NPI | 1033667183 |
---|---|
Provider Name | Mrs. Genoveva C Felisgrau |
First Address | Miami, FL 33173-3146 |
Second Address | Miami, FL 33173-3146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2016 |
Last Update Date | 19/09/2016 |