Provider Demographics
NPI:1982141057
Name:CORVISON, EDUARDO (RN)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:CORVISON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 MASSEY AVE
Mailing Address - Street 2:NBHC NAVAL STATION MAYPORT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32228-0148
Mailing Address - Country:US
Mailing Address - Phone:904-270-4229
Mailing Address - Fax:904-827-4485
Practice Address - Street 1:2104 MASSEY AVE
Practice Address - Street 2:NBHC NAVAL STATION MAYPORT
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32228-0148
Practice Address - Country:US
Practice Address - Phone:904-270-4229
Practice Address - Fax:904-827-4485
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9345351163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health