Organization
ADVANCE PRACTICE PRACTITIONER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLISTAIR MCDONALD SMITH (CEO/PHYSICIAN ASSISTANT)
(954) 993-0542
Entity
Organization
Contact information
Practice address
8526 NEMOURS PKWY, ORLANDO, FL 32827-7752
(954) 993-0542
Mailing address
8526 NEMOURS PKWY, ORLANDO, FL 32827-7752
(954) 993-0542
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932682432
NA
FL
05
—
1932682432
—
FL
01
—
1952884389
NA
FL
05
—
1952884389
—
FL
Enumeration date
12/13/2023
Last updated
12/13/2023
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