Individual provider · Type 1 NPI

Mariya Bozhenok, PA-C

Primary Care Nurse Practitioner · Fort Myers, FL

NPI number 1194077487 Active

Practice location

4101 Evans Ave
Fort Myers, FL 33901

Fax (239) 790-2432

Mailing address

PO Box 111600
Naples, FL 34108-0127

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300XPA9106816 (FL)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1194077487

Mariya Bozhenok, PA-C's National Provider Identifier is 1194077487, issued on Oct 10, 2012. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fort Myers, FL. The record was last updated on Jun 1, 2016.