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Individual

DAISY BABY PULINILKUMKALAYIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1426 W. BUSH BLVD. SUITE #105, SUITE #105, TAMPA, FL 33612
(813) 935-0225
Mailing address
10805 CARLOWAY HILLS DR, WIMAUMA, FL 33598-6143
(813) 270-0086

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9228951
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN9228951
FLORIDA BOARD OF NURSING
FL
Enumeration date
10/26/2018
Last updated
10/26/2018
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