Healthcare Provider Details
I. General information
NPI: 1477935245
Provider Name (Legal Business Name): PRAGATI GUSMANO ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/29/2015
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1414 GAY RD SUITE 204
WINTER PARK FL
32789-2928
US
IV. Provider business mailing address
1414 GAY RD SUITE 204
WINTER PARK FL
32789-2928
US
V. Phone/Fax
- Phone: 321-209-1689
- Fax:
- Phone: 321-209-1689
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | ND-268 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: