Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP1737822 | FL |
NPI | 1003847831 |
---|---|
Provider Name | Ms. Julie Ann Berthy |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 11/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P57022 | (02) |