Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP 9205104 | FL |
NPI | 1003263724 |
---|---|
Provider Name | Susan Buffington |
First Address | St Petersburg, FL 33701-4634 |
Second Address | St Petersburg, FL 33701-4634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2016 |
Last Update Date | 23/05/2016 |