MEDICARE: ERIN RISAVI TONGUE NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	APRN11010203	FL

General Provider Information

NPI Number	:	1083215446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN RISAVI TONGUE NP-C

Provider Business Mailing Address
First Line	:	8246 BELLOW ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7224
Country	:	US
Telephone Number	:	607-341-6559
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 TIMBERLACHEN CIR STE 2005
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-3337
Country	:	US
Telephone Number	:	407-783-8173
Fax Number	:	407-675-6388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	04/20/2026

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