Individual
ETHAN DILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1222 S ORANGE AVE FL 4, ORLANDO, FL 32806-1215
(321) 841-6444
Mailing address
1222 S ORANGE AVE FL 4, ORLANDO, FL 32806-1215
(321) 841-6444
(407) 650-1307
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11021751
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11021751
FL
Other
Enumeration date
09/08/2022
Last updated
10/14/2022
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