Provider Demographics
NPI:1891246096
Name:MINGACHEVA, ALBINA VALEYEVNA (NP)
Entity Type:Individual
Prefix:
First Name:ALBINA
Middle Name:VALEYEVNA
Last Name:MINGACHEVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALBINA
Other - Middle Name:
Other - Last Name:MINGACHEVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2200 OSPREY BLVD FL 33830
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-3308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 OSPREY BLVD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-3308
Practice Address - Country:US
Practice Address - Phone:863-533-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-22
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173893363L00000X
FLAPRN11013745363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner