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Individual

IRINA LYTVYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(278) 682-1517
Mailing address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9329931
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011671100
FL
01
Y0MA3
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/11/2013
Last updated
04/12/2021
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