Individual
KWANG JIN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
9400 TURKEY LAKE RD, ORLANDO, FL 32819-8001
(407) 351-8500
(407) 345-9765
Mailing address
7350 FUTURES DR STE 1, ORLANDO, FL 32819-9082
(321) 214-0028
(407) 429-3833
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11017162
FL
363LF0000X
Family Nurse Practitioner
11017162
FL
Other
Enumeration date
01/06/2022
Last updated
10/24/2023
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