Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 11012592 | FL |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN11012592 | FL |
NPI | 1477127157 |
---|---|
Provider Name | Ms. Luisa Fernanda Alzate Benjumea |
First Address | Orlando, FL 32806-1110 |
Second Address | Orlando, FL 32806-1110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2021 |
Last Update Date | 18/10/2021 |