Individual
JEAN PATRICK IDELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
962 LAKE DOE BLVD, APOPKA, FL 32703-1648
(407) 715-4258
Mailing address
962 LAKE DOE BLVD, APOPKA, FL 32703-1648
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11043379
FL
Other
Enumeration date
11/01/2025
Last updated
11/01/2025
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