Individual
JULISSA TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
8260 GLADIOLUS DR, FORT MYERS, FL 33908-4156
(239) 437-5755
(239) 437-5776
Mailing address
4371 VERONICA S SHOEMAKER BLVD, FORT MYERS, FL 33916-2216
(239) 236-5711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9380884
FL
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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