Individual
MRS. LATRECE N ATHOURISTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5449 S SEMORAN BLVD STE 20, ORLANDO, FL 32822-1778
(407) 734-1273
Mailing address
8566 NEMOURS PKWY, ORLANDO, FL 32827-7752
(314) 443-8455
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11000703
FL
363LP2300X
Primary Care Nurse Practitioner
11000703
FL
363LP2300X
Primary Care Nurse Practitioner
309035
NY
Other
Enumeration date
01/25/2019
Last updated
10/20/2023
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