Healthcare Provider Details

I. General information

NPI: 1730811696
Provider Name (Legal Business Name): ABY VIRUTHIPARAMPIL JOSEPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ABY V JOSEPH

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 OCOEE APOPKA RD STE 230
APOPKA FL
32703-9210
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 407-609-7510
  • Fax: 407-609-1511
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11020019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: