Dacosta-Green, Ophelia

Dacosta-Green, Ophelia is an individual health care provider with primary practice located at 2217 North Blvd W , Davenport FL 33837-8990. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dacosta-Green, Ophelia can be contacted via phone (863) 421-3456.

Contact Information

Primary practice address
2217 North Blvd W Davenport FL 33837-8990
Phone: (863) 421-3456
Fax: (863) 421-3466
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9199962 Florida

Profile Details

NPI number 1053826297
LBN Legal business name Dacosta-Green, Ophelia
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2017
Last updated Dec 26th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053826297 NPPES
Florida Other NP9199962 FNP CERTIFICATION NUMBER

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