Healthcare Provider Details

I. General information

NPI: 1760886717
Provider Name (Legal Business Name): REBEKAH R ATKINS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 PRIMERA BLVD STE 135
LAKE MARY FL
32746-2149
US

IV. Provider business mailing address

735 PRIMERA BLVD STE 135
LAKE MARY FL
32746-2149
US

V. Phone/Fax

Practice location:
  • Phone: 407-321-0085
  • Fax:
Mailing address:
  • Phone: 407-321-0085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9331266
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9331266
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN9331266
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: