Healthcare Provider Details

I. General information

NPI: 1578386231
Provider Name (Legal Business Name): PARASKEVI GEORGIE HIMONETOS MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STATE ROAD 54
TRINITY FL
34655-1808
US

IV. Provider business mailing address

6255 RIDGE TOP DR
TRINITY FL
34655-5609
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4000
  • Fax:
Mailing address:
  • Phone: 727-947-2373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11036310
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: