Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN9179783 | FL |
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN9179783 | FL |
NPI | 1033309992 |
---|---|
Provider Name | Patricia Silcox Pendry |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33606-3571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 31/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102416600 | (05) | FL |
U5HWZ | BLUE CROSS BLUE SHIELD (01) | FL |