Individual
BLONDIE DEMOSTHENE VICTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
11748 ALBATROSS LN, RIVERVIEW, FL 33569-6300
(803) 727-5850
Mailing address
11748 ALBATROSS LN, RIVERVIEW, FL 33569-6300
(803) 727-5850
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11019797
FL
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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