Healthcare Provider Details

I. General information

NPI: 1548887581
Provider Name (Legal Business Name): DEVON BRUNO MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 WEKIVA COMMONS CIR
APOPKA FL
32712-3645
US

IV. Provider business mailing address

515 WEKIVA COMMONS CIR
APOPKA FL
32712-3645
US

V. Phone/Fax

Practice location:
  • Phone: 407-464-9516
  • Fax: 407-464-9519
Mailing address:
  • Phone: 407-464-9516
  • Fax: 407-464-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11000795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: