Individual
MRS. THARA GOPINATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
701 UNION ST, KISSIMMEE, FL 34741-5007
(407) 952-3242
Mailing address
13527 BUDWORTH CIR, ORLANDO, FL 32832-6111
(407) 952-3242
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11012036
FL
363LP2300X
Primary Care Nurse Practitioner
11012036
FL
Other
Enumeration date
03/09/2021
Last updated
11/27/2021
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