Mallory M Gustafson, ARNP | |
632 E Victoria Trails Blvd, Deland, FL 32724-7911 | |
(970) 443-0948 | |
Not Available |
Full Name | Mallory M Gustafson |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 632 E Victoria Trails Blvd, Deland, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144728486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | ARNP9383627 (Florida) | Primary |
Entity Name | Emergency Physicians Of Central Florida Llp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326033341 PECOS PAC ID: 1850296567 Enrollment ID: O20031205000109 |
Entity Name | Lewis & Klancke Cardiology Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669589263 PECOS PAC ID: 6305731860 Enrollment ID: O20040216000513 |
Mailing Address | Practice Location Address |
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Mallory M Gustafson, ARNP 632 E Victoria Trails Blvd, Deland, FL 32724-7911 Ph: (970) 443-0948 | Mallory M Gustafson, ARNP 632 E Victoria Trails Blvd, Deland, FL 32724-7911 Ph: (970) 443-0948 |
Deborah Vega Darnell, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 999 W Plymouth Ave, Deland, FL 32720 Phone: 386-740-7080 Fax: 386-734-0821 | |
Dr. Mary Theresa Izzo, PHD, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 999 W Plymouth Ave, Deland, FL 32720 Phone: 386-740-7080 Fax: 386-734-0821 | |
Lisa Cunningham, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 685 Peachwood Dr, Deland, FL 32720 Phone: 386-736-3463 Fax: 386-736-3492 | |
Ms. Carmelia Maria Lee, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2370 E International Speedway Blvd, Deland, FL 32724 Phone: 386-736-1105 Fax: 386-734-1443 | |
Carolyn Cobb Stewart, ARNP, BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2239 S Woodland Blvd, Deland, FL 32720 Phone: 386-279-0151 Fax: 386-279-0148 | |
Brooke A Lacey, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 809 N Stone St, Deland, FL 32720 Phone: 386-734-1824 Fax: 386-738-7497 |