Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | ARNP9337357 | FL |
NPI | 1003267386 |
---|---|
Provider Name | Rohona Mascharak |
First Address | Pensacola, FL 32502-5904 |
Second Address | Navarre, FL 32566-7309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2016 |
Last Update Date | 28/06/2016 |