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Organization
EXPRESS PROVIDER SERVICES PLLC
Active
Organization
EXPRESS PROVIDER SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY RALEY APRN (OWNER)
(407) 221-1679
Entity
Organization
Contact information
Practice address
8130 LAKEWOOD MAIN ST STE 103, LAKEWOOD RANCH, FL 34202-5068
(407) 221-1679
Mailing address
8130 LAKEWOOD MAIN ST STE 103, LAKEWOOD RANCH, FL 34202-5068
(407) 221-1679
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9298097
APRN LICENSE
FL
Enumeration date
04/28/2022
Last updated
08/17/2022
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