Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | ARNP 9292120 | FL |
NPI | 1003212762 |
---|---|
Provider Name | Ralitza Georgieva |
First Address | Plantation, FL 33317-1611 |
Second Address | Plantation, FL 33317-1611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2014 |
Last Update Date | 07/11/2014 |