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Individual

MS. MARIYA BOZHENOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4101 EVANS AVE, FORT MYERS, FL 33901
(239) 939-3456
(239) 790-2432
Mailing address
PO BOX 111600, NAPLES, FL 34108-0127
(239) 333-0630
(239) 333-0631

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
PA9106816
FL

Other

Enumeration date
10/10/2012
Last updated
06/01/2016
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