Healthcare Provider Details

I. General information

NPI: 1144319294
Provider Name (Legal Business Name): DEBORAH A PHILLIPS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 CITRUS TOWER BLVD
CLERMONT FL
34711-6803
US

IV. Provider business mailing address

10407 CARLSON CIR
CLERMONT FL
34711-7883
US

V. Phone/Fax

Practice location:
  • Phone: 352-242-1500
  • Fax: 352-242-0053
Mailing address:
  • Phone: 352-242-1500
  • Fax: 352-242-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number9199917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: