Healthcare Provider Details

I. General information

NPI: 1891404380
Provider Name (Legal Business Name): UMA DURAIRAJ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W PLYMOUTH AVE
DELAND FL
32720-2753
US

IV. Provider business mailing address

1500 BEVILLE RD STE 105
DAYTONA BEACH FL
32114-5644
US

V. Phone/Fax

Practice location:
  • Phone: 386-873-2963
  • Fax: 386-873-2786
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022063
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11022063
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: