Provider Demographics
NPI:1063523389
Name:MINKOW, FLORENCE J (NP)
Entity type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:J
Last Name:MINKOW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:J
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:455 W 5TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4413
Practice Address - Country:US
Practice Address - Phone:775-688-5555
Practice Address - Fax:775-688-5598
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN 00801363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
R59709Medicare UPIN
101289Medicare ID - Type Unspecified