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General NPI Number Information
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NPI Number | 1598351835
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Entity Type | Individual
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Provider Name | RASHA BOTROS FNP
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Gender | Female
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 12/20/2020
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Provider Practice Location Address
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Address Line | 810 WILDWOOD ST
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-4568
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Country | US
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Telephone | 386-258-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 CREEKWATER BLVD
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City | PORT ORANGE
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State | FL
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Zip | 32128-4088
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Country | US
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Telephone | 386-383-9546
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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 | APRN11010717
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License Number State | FL
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