Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9175385 | FL |
NPI | 1023486032 |
---|---|
Provider Name | Mrs. Lydia Adebola Onatunde |
First Address | Longwood, FL 32779-3112 |
Second Address | Longwood, FL 32779-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2015 |
Last Update Date | 08/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36 | (02) | FL |