Individual
SUMMER ABUKHODEIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
858 REDWOOD WAY, LAKE WALES, FL 33898-9130
(863) 232-7604
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP9384750
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105431300
—
FL
01
—
J2DQT
BLUE CROSS BLUE SHIELD
FL
01
—
L6972
MEDICARE
FL
Enumeration date
05/20/2017
Last updated
07/21/2022
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