Provider Demographics
NPI:1407567860
Name:EPSTEIN, DEBORAH VIDA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:VIDA
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 COWART ROAD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33567
Mailing Address - Country:US
Mailing Address - Phone:727-744-7880
Mailing Address - Fax:
Practice Address - Street 1:625 EAST ALEXANDER STREET
Practice Address - Street 2:UNIT 625
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563
Practice Address - Country:US
Practice Address - Phone:727-744-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN713212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily