Doctor Name: | MRS. HELEN POTESTAS CORONICA |
NPI Number: | 1235547258 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 9342217 |
Business Practice Address: | 2814 14th Ave Se Ruskin, FL - 335705471 |
Business Phone Number: | 8133497800 |
Business Fax Number: | 8139386421 |
Mailing Address: | 13110 Elk Mountain Dr, RIVERVIEW |
State: | FL |
Postal Code: | 335797182 |
Phone Number: | 8136536208 |
Fax Number: | 8136852110 |
NPI Enumeration Date: | 07/23/2014 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 9342217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |