Individual
JAE WON LIM LAYUG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 LIONEL WAY, DAVENPORT, FL 33837-7811
(863) 353-1390
(863) 438-4880
Mailing address
405 LIONEL WAY, DAVENPORT, FL 33837-7811
(863) 353-1390
(863) 438-4880
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11026214
FL
363LC0200X
Critical Care Medicine Nurse Practitioner
11026214
FL
Other
Enumeration date
05/10/2023
Last updated
10/10/2023
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