Individual
DR. DOREEN RADJENOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3759
(904) 390-3429
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1607022
FL
363LP0200X
Pediatric Nurse Practitioner
ARNP1607022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257733000
—
FL
05
—
783679869A
—
GA
Enumeration date
09/27/2006
Last updated
09/16/2011
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