Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | ARNP9353073 | FL |
NPI | 1003211004 |
---|---|
Provider Name | Wieslaw Faliszewski |
First Address | Melbourne, FL 32901-3122 |
Second Address | Rockledge, FL 32955-3133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2014 |
Last Update Date | 31/08/2017 |