Individual
KASSIDY MARIE BOLIEK-GELB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11948 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6601
(813) 236-9000
Mailing address
3407 GRAY WHETSTONE ST, BRANDON, FL 33511-7792
(352) 255-8964
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11027823
FL
Other
Enumeration date
08/01/2023
Last updated
10/02/2024
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