Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN11003933 | FL |
NPI | 1003466459 |
---|---|
Provider Name | Nancy Assani |
First Address | Plantation, FL 33324-3923 |
Second Address | Coral Springs, FL 33067-1993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2019 |
Last Update Date | 15/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104299900 | (05) | FL |