Healthcare Provider Details

I. General information

NPI: 1902400187
Provider Name (Legal Business Name): ASHLEY REHMANN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2020
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5655 S ORANGE AVE
EDGEWOOD FL
32809-4289
US

IV. Provider business mailing address

5655 S ORANGE AVE
EDGEWOOD FL
32809-4289
US

V. Phone/Fax

Practice location:
  • Phone: 866-742-6655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9410635
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11011100
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: