Individual
RENEE SANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1055 SAXON BLVD, ORANGE CITY, FL 32763-8468
(386) 917-7108
(386) 917-7293
Mailing address
10193 OAK CREST RD, ORLANDO, FL 32829-8251
(407) 987-9752
(772) 223-6354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11028816
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11028816
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111953100
—
FL
Enumeration date
09/22/2021
Last updated
01/12/2026
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