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Individual

MS. BETSY SUZANNE CIROLIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3505 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2130
(904) 438-7683
Mailing address
300 WILMOT RD MS # 3113, DEERFIELD, IL 60015-4614
(800) 825-5467

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2065772
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001685500
FL
05
3002641 00
FL
01
E3331Y
MEDICARE PTAN
FL
Enumeration date
02/28/2007
Last updated
03/18/2015
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