Individual
AMBER PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5900 S JOHN YOUNG PKWY, ORLANDO, FL 32839-3716
(407) 398-6470
Mailing address
50 OLIVETTE ST, ST JOHNS, FL 32259-8640
(904) 237-5785
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
APRN9374077
FL
363LP0200X
Pediatric Nurse Practitioner
ARNP9374077
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106085000
—
FL
Enumeration date
01/17/2014
Last updated
01/20/2023
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