Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | ARNP2605142 | FL |
NPI | 1023208873 |
---|---|
Provider Name | Ms. Ester Llarinas Gamboa |
First Address | Lake City, FL 32055-7258 |
Second Address | Lake City, FL 32025-5808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2007 |
Last Update Date | 27/07/2007 |