Provider Demographics
NPI:1770179996
Name:FROMETA, BLONDINE CHARLINE (ARNP-FNP-C)
Entity Type:Individual
Prefix:
First Name:BLONDINE
Middle Name:CHARLINE
Last Name:FROMETA
Suffix:
Gender:F
Credentials:ARNP-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CHAMPIONS VUE LOOP UNIT 201
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-4865
Mailing Address - Country:US
Mailing Address - Phone:954-203-9254
Mailing Address - Fax:
Practice Address - Street 1:210 CHAMPIONS VUE LOOP UNIT 201
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33897-4865
Practice Address - Country:US
Practice Address - Phone:954-203-9254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty