Individual
IDONGESIT EDET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11630 BALINTORE DR, RIVERVIEW, FL 33579-3908
(813) 616-0446
Mailing address
11630 BALINTORE DR, RIVERVIEW, FL 33579-3908
(813) 616-0446
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
5631861
NY
163W00000X
Registered Nurse
Primary
RN9416423
FL
Other
Enumeration date
06/03/2014
Last updated
03/17/2018
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