Individual
KAILEY TERRA ASETOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7015 BERACASA WAY STE 201, BOCA RATON, FL 33433-3453
(561) 477-7728
Mailing address
4537 CALOOSA PINES RD, BOYNTON BEACH, FL 33436-6103
(708) 212-4515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11002203
FL
Other
Enumeration date
05/22/2019
Last updated
06/11/2019
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