Provider Demographics
NPI:1013465962
Name:NEVLOUS, VERNADINA
Entity Type:Individual
Prefix:
First Name:VERNADINA
Middle Name:
Last Name:NEVLOUS
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 1:4824 CYPRESS WOODS DR APT 272
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-3505
Mailing Address - Country:US
Mailing Address - Phone:754-779-3459
Mailing Address - Fax:
Practice Address - Street 1:4824 CYPRESS WOODS DR APT 272
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-3505
Practice Address - Country:US
Practice Address - Phone:754-779-3459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator