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General NPI Number Information
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NPI Number | 1487463501
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Entity Type | Individual
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Provider Name | SUADA MUMINOVIC
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 533 W TWINCOURT TRL STE AND702
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32095-8884
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Country | US
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Telephone | 904-990-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 13826 ZION GATE CT
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0283
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Country | US
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Telephone | 904-514-1471
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11036245
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License Number State | FL
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