Provider Demographics
NPI:1881083806
Name:SCILLA, ANTONINA (NP)
Entity type:Individual
Prefix:
First Name:ANTONINA
Middle Name:
Last Name:SCILLA
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:HCR MANORCARE MEDICAL SERVICES OF FLORIDA,, LLC
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2615
Mailing Address - Country:US
Mailing Address - Phone:419-252-6018
Mailing Address - Fax:800-564-5952
Practice Address - Street 1:1265 S CEDAR CREST BLVD
Practice Address - Street 2:HEARTLAND CARE PARTNERS
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6293
Practice Address - Country:US
Practice Address - Phone:419-252-6018
Practice Address - Fax:800-564-5952
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP014688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner