Consolacion Liceth Becerra, RN-BC
Nurse Practitioner, Primary Care in Kissimmee, FL. Individual provider (NPI-1).
NPI number1619405461
StatusActive
Last updated in NPPESMar 27, 2024
Details
- NPI
- 1619405461
- Entity type
- Individual (NPI-1)
- Name
- Ms. Consolacion Liceth Becerra
- Credential
- RN-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 24, 2017
- Certification date
- Mar 27, 2024
- Last updated
- Mar 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 11025765 | FL | Yes |
| 163WP0808X | Registered Nurse, Psych/Mental Health | 9175391 | FL | |
| 363LA2200X | Nurse Practitioner, Adult Health | 11025765 | FL | |
| 363LG0600X | Nurse Practitioner, Gerontology | 11025765 | FL |
Other names
- Consolacion Liceth Huerfano (Former Name)
Practice location
100 Park Place Blvd Ste 201Kissimmee, FL 34741-2326
Phone 407-766-4519
Mailing address
100 Park Place Blvd Ste 201Kissimmee, FL 34741-2326
Phone 407-766-4519
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