Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9332663 | FL |
NPI | 1013391994 |
---|---|
Provider Name | Tanya Paradiso Dilmuth |
First Address | Jacksonville, FL 32256-9680 |
Second Address | Jacksonville, FL 32256-9680 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 10/07/2015 |