Blondie Demosthene Victor, AGNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11019797 Issued in FL

Practice address

11748 Albatross LN
Riverview, FL 33569-6300

Phone

(803) 727-5850

NPI assigned

Jan 18, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Blondie Demosthene Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1174238653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11748 ALBATROSS LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696300",
            "telephone_number": "803-727-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11748 ALBATROSS LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696300",
            "telephone_number": "803-727-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "BLONDIE",
        "middle_name": "DEMOSTHENE",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11019797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLONDIE",
            "last_name": "DEMOSTHENE",
            "credential": "AGNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jenine Ventre
• Richard Veres
• Verimed Health Group, Riverview LLC
• Laura Elizabeth Verstrat
• Kimberlee Jane Vickers, P.T.
• Victory Hands Healthcare LLC
• Maria Karla Vidal Guas
• Maria Lourdes Vidovich, MD
• Viessence Healthcare LLC
• Justin Taylor Vigo I

• Nurse Practitioner in Riverview, FL
• Providers in Riverview, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.