Healthcare Provider Details

I. General information

NPI: 1316266448
Provider Name (Legal Business Name): EMINE JULIDE COMER A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 SOUTH WOODS DRIVE
ROCKLEDGE FL
32955-3262
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-636-3066
  • Fax: 321-636-2545
Mailing address:
  • Phone: 321-636-3066
  • Fax: 321-636-2545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9235496
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9235496
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: