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General NPI Number Information
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NPI Number | 1417381674
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Entity Type | Individual
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Provider Name | MIRJANA TOMASEVIC NP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1095 WHIPPOORWILL LN
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City | NAPLES
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State | FL
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Zip | 34105-3800
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Country | US
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Telephone | 239-261-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 8820 WALTER WAY UNIT 1409
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City | NAPLES
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State | FL
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Zip | 34120-0762
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Country | US
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Telephone | 646-752-0938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9288997
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License Number State | FL
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