Healthcare Provider Details

I. General information

NPI: 1811729536
Provider Name (Legal Business Name): MARIA ALEJANDRA RICAURTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CELEBRATION PL FL 2
CELEBRATION FL
34747-4606
US

IV. Provider business mailing address

380 CELEBRATION PL FL 2
CELEBRATION FL
34747-4606
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4078
  • Fax:
Mailing address:
  • Phone: 407-303-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11034894
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11034894
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: