Healthcare Provider Details

I. General information

NPI: 1356213490
Provider Name (Legal Business Name): ADRIANA ELENA RIFENDIFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BOSTON AVE STE 206
ALTAMONTE SPRINGS FL
32701-4712
US

IV. Provider business mailing address

3501 STAR LN APT 208
FORT MYERS FL
33916-9570
US

V. Phone/Fax

Practice location:
  • Phone: 321-204-9127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95037132
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number329488
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11042269
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: