Healthcare Provider Details

I. General information

NPI: 1194478206
Provider Name (Legal Business Name): MEGAN PEARL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 E SEMORAN BLVD STE 258
APOPKA FL
32703-5900
US

IV. Provider business mailing address

1766 AMERICUS MINOR DR
WINTER GARDEN FL
34787-2174
US

V. Phone/Fax

Practice location:
  • Phone: 321-248-8000
  • Fax:
Mailing address:
  • Phone: 407-394-9387
  • Fax: 321-999-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF10210260
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: