Healthcare Provider Details

I. General information

NPI: 1164975660
Provider Name (Legal Business Name): RITA VIJAY MANSUKHANI-SHAIBU ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RITA VIJAY MANSUKHANI-SHAIBU ARNP

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 OCOEE APOPKA RD
APOPKA FL
32703-9210
US

IV. Provider business mailing address

2100 OCOEE APOPKA RD
APOPKA FL
32703-9210
US

V. Phone/Fax

Practice location:
  • Phone: 407-652-7026
  • Fax:
Mailing address:
  • Phone: 407-652-7026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9278883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: