MEDICARE: NYLIN PRUDENT APRN, FNP-BC

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	363LF0000X	Family Nurse Practitioner	APRN11023363	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710699319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NYLIN PRUDENT APRN, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 850001, DEPT 8340
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32885-0001
Country	:	US
Telephone Number	:	813-536-7277
Fax Number	:	855-830-1722

Provider Business Practice Location Address
First Line	:	971 VILLAGE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1944
Country	:	US
Telephone Number	:	561-688-5030
Fax Number	:	561-688-9565

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

Provider Enumeration Date	:	12/15/2022
Last Update Date	:	12/11/2025

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