Basic Information
Provider Information
NPI: 1205350113
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DRAGIEVA
FirstName: SILVIYA
MiddleName: GENEVA
NamePrefix: MS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22 W UNDERWOOD ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061110
CountryCode: US
TelephoneNumber: 4076483800
FaxNumber: 4074255203
Practice Location
Address1: 22 W UNDERWOOD ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061110
CountryCode: US
TelephoneNumber: 4076483800
FaxNumber: 4078727754
Other Information
ProviderEnumerationDate: 08/01/2017
LastUpdateDate: 06/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X9352972FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LA2200XARNP9352972FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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