HomeNPI Verification

NPI Verification

National Provider Identifier: 1952009995

1977 Enterprise LLC

Organization

Primary Specialty

Nurse Practitioner

Code: 363L00000X

All Specialties (10)

Family Medicine, Sports Medicine

Code: 207QS0010X

Psychiatry & Neurology, Addiction Medicine

Code: 2084A0401X

Psychiatry & Neurology, Psychiatry

Code: 2084P0800X

Hospitalist

Code: 208M00000X

Physician Assistant

Code: 363A00000X

Nurse Practitioner

Code: 363L00000X

Primary

Nurse Practitioner, Adult Health

Code: 363LA2200X

Nurse Practitioner, Family

Code: 363LF0000X

Nurse Practitioner, Psych/Mental Health

Code: 363LP0808X

Nurse Practitioner, Primary Care

Code: 363LP2300X

Practice Address

450 S ORANGE AVE FL 3

ORLANDO, FL 328013394

Phone: 407-212-7113

NPI Enumeration Date

February 20, 2023

NPI Number

1952009995

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry