Individual
SOSAMMA K MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3262 VINELAND RD, SUITE 102, KISSIMMEE, FL 34746-4839
(866) 422-7367
(407) 809-5243
Mailing address
3262 VINELAND RD, SUITE 102, KISSIMMEE, FL 34746-4839
(866) 422-7367
(407) 809-5243
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
A1106083
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP1809802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308052800
—
FL
Enumeration date
12/08/2006
Last updated
07/25/2013
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