Provider Demographics
NPI:1427215367
Name:NORBERT, NYRVA
Entity Type:Individual
Prefix:
First Name:NYRVA
Middle Name:
Last Name:NORBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 HOWLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-9738
Mailing Address - Country:US
Mailing Address - Phone:407-324-0788
Mailing Address - Fax:
Practice Address - Street 1:1225 HOWLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-9738
Practice Address - Country:US
Practice Address - Phone:407-324-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor