MEDICARE: MRS. GENOVEVA C FELISGRAU ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	9213983	FL
2	363LF0000X	Family Nurse Practitioner	9213983	DE
3	363LP2300X	Primary Care Nurse Practitioner	9213983	FL

General Provider Information

NPI Number	:	1033667183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GENOVEVA C FELISGRAU ARNP

Provider Business Mailing Address
First Line	:	7735 SW 99TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3146
Country	:	US
Telephone Number	:	305-596-5714
Fax Number	:

Provider Business Practice Location Address
First Line	:	7735 SW 99TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3146
Country	:	US
Telephone Number	:	305-596-5714
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2016
Last Update Date	:	09/19/2016

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