Healthcare Provider Details

I. General information

NPI: 1891656096
Provider Name (Legal Business Name): WADE R CONNETT APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 NORTHLAKE BLVD STE 1008
ALTAMONTE SPRINGS FL
32701-4335
US

IV. Provider business mailing address

270 NORTHLAKE BLVD STE 1008
ALTAMONTE SPRINGS FL
32701-4335
US

V. Phone/Fax

Practice location:
  • Phone: 407-834-3300
  • Fax:
Mailing address:
  • Phone: 407-834-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11041834
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11041834
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: