Individual
ETLEVA NASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11701-32 SAN JOSE BLVD, #103, JACKSONVILLE, FL 32223
(904) 262-9075
(904) 262-9076
Mailing address
11701-32 SAN JOSE BLVD, #103, JACKSONVILLE, FL 32223
(904) 262-9075
(904) 262-9076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME116321
FL
Other
Enumeration date
06/10/2013
Last updated
12/05/2013
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