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Individual

LILLIAN DEVITO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-BC

Contact information

Practice address
201 E SAMPLE RD, DEERFIELD BEACH, FL 33064-3502
(954) 786-6460
(954) 786-7304
Mailing address
1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
(954) 786-6460
(954) 786-7304

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704289794
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
6759
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110743200
FL
Enumeration date
06/14/2016
Last updated
04/03/2024
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