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Laksamana Perintis Nusantara, NP
Family Nurse Practitioner in Delray Beach, Florida
NPI 1205610607

Laksamana Perintis Nusantara is a Family Nurse Practitioner based in Fort Lauderdale, FL and is specialized in Family. Laksamana Perintis Nusantara practices in Delray Beach, FL and has the professional credentials of NP. The NPI Number for Laksamana Perintis Nusantara is 1205610607 and holds a License No. 11027192 (Florida).

The current practice location address for Laksamana Perintis Nusantara is 5162 Linton Blvd Ste 107, Delray Beach, FL and can be reached out via phone at 561-499-8686.

Location: 5162 Linton Blvd Ste 107, Delray Beach, FL, 33301-4144
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205610607
Provider Name
Laksamana Perintis Nusantara
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
5162 Linton Blvd Ste 107, Delray Beach, FL, 33301-4144
Phone Number
561-499-8686
Fax Number
Provider Enumeration Date
08/24/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5162 Linton Blvd Ste 107
City
Delray Beach
State
Florida
Zip
33484-6567
Phone Number
561-499-8686
Fax Number
person
Provider Business Mailing Address Details
Address
5162 Linton Blvd Ste 107
City
Delray Beach
State
Florida
Zip
33484-6567
Phone Number
561-499-8686
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
11027192 (Florida)
Definition
Definition to come...
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