Healthcare Provider Details

I. General information

NPI: 1548034416
Provider Name (Legal Business Name): ASTRID LIED APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 PRIMERA BLVD STE 1031
LAKE MARY FL
32746-2190
US

IV. Provider business mailing address

157 SPRINGWOOD CIR APT D
LONGWOOD FL
32750-5048
US

V. Phone/Fax

Practice location:
  • Phone: 407-537-5619
  • Fax: 321-204-7073
Mailing address:
  • Phone: 407-415-1625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11029316
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11029316
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: