Healthcare Provider Details

I. General information

NPI: 1992697270
Provider Name (Legal Business Name): REBECCA FITZGERALD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2025
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 HERITAGE DR STE 203
JUPITER FL
33458-3029
US

IV. Provider business mailing address

143 TIMBERWALK TRL
JUPITER FL
33458-5574
US

V. Phone/Fax

Practice location:
  • Phone: 561-354-1515
  • Fax:
Mailing address:
  • Phone: 561-319-2922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11037583
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: