Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 11008491 | FL |
NPI | 1588280325 |
---|---|
Provider Name | Mrs. Zoe Stewart Griffin |
First Address | Deland, FL 32720-4076 |
Second Address | Orange City, FL 32763-8360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2020 |
Last Update Date | 05/08/2020 |