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Individual

MRS. AMY PENALOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
736 S DILLARD ST STE 2, WINTER GARDEN, FL 34787-3975
(407) 614-4866
Mailing address
1522 ALLIGATOR ST, SAINT CLOUD, FL 34771-7538
(352) 999-2809

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11033599
FL
363LF0000X
Family Nurse Practitioner
11033599
FL
363LP2300X
Primary Care Nurse Practitioner
11033599
FL

Other

Enumeration date
06/27/2024
Last updated
06/27/2024
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