Healthcare Provider Details

I. General information

NPI: 1104374164
Provider Name (Legal Business Name): RAILET RODRIGUEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 DOUGLAS AVE
ALTAMONTE SPRINGS FL
32714-2084
US

IV. Provider business mailing address

121 S ORANGE AVE STE 940
ORLANDO FL
32801-3234
US

V. Phone/Fax

Practice location:
  • Phone: 407-332-0003
  • Fax: 321-295-7928
Mailing address:
  • Phone: 407-658-9687
  • Fax: 407-658-9688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9241225
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: