Provider Demographics
NPI:1265678015
Name:BIT-IVAN, ESTHER NONI (DO)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:NONI
Last Name:BIT-IVAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:203 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-6865
Mailing Address - Country:US
Mailing Address - Phone:912-261-2669
Mailing Address - Fax:912-261-0561
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:912-261-2669
Practice Address - Fax:912-261-0561
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125054795207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology