Individual
KATIA TOLEDO CERQUEIRA GANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN9266612
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9266612
FL
Other
Enumeration date
03/10/2010
Last updated
07/31/2013
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