Healthcare Provider Details

I. General information

NPI: 1841067337
Provider Name (Legal Business Name): REBECCA ASHLEY FLOYD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA ASHLEY FOLL

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 DON WICKHAM DR
CLERMONT FL
34711-1979
US

IV. Provider business mailing address

12130 STILL MEADOW DR
CLERMONT FL
34711-6649
US

V. Phone/Fax

Practice location:
  • Phone: 352-241-7180
  • Fax:
Mailing address:
  • Phone: 352-978-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11029921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: