Healthcare Provider Details
I. General information
NPI: 1508681594
Provider Name (Legal Business Name): NP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5360 GLOVER LN
MILTON FL
32570-4189
US
IV. Provider business mailing address
5931 PARSONAGE CIR
MILTON FL
32570-8927
US
V. Phone/Fax
- Phone: 850-626-9225
- Fax:
- Phone: 850-384-5373
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGELO
MARCUS
MISHIO
Title or Position: OWNER
Credential: ARNP
Phone: 850-384-5373