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Individual

BETH ANN DECORDOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1421 MALABAR RD NE, PALM BAY, FL 32907-2576
(321) 434-8531
(321) 434-8533
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-8531

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9433193
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019314300
FL
01
IU177Z
MEDICARE HF
FL
Enumeration date
02/21/2013
Last updated
07/23/2024
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