Healthcare Provider Details

I. General information

NPI: 1831559202
Provider Name (Legal Business Name): SHERLY POULOSE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

IV. Provider business mailing address

10000 W COLONIAL DR STE 484
OCOEE FL
34761-3436
US

V. Phone/Fax

Practice location:
  • Phone: 407-767-7262
  • Fax: 407-775-5002
Mailing address:
  • Phone: 321-841-6444
  • Fax: 407-650-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9269900
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9269900
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: