Individual
NELY GABASA VILLAVICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
2750 N MCMULLEN BOOTH RD, SUITE 102-E, CLEARWATER, FL 33761-3362
(813) 944-2178
(813) 343-8107
Mailing address
2750 N MCMULLEN BOOTH RD, SUITE 102-E, CLEARWATER, FL 33761-3362
(813) 944-2178
(813) 343-8107
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
299993080
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299993080
STATE LICENSE NUMBER
FL
Enumeration date
05/07/2008
Last updated
02/23/2009
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