Healthcare Provider Details

I. General information

NPI: 1720873094
Provider Name (Legal Business Name): RAKHSHI NOOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 TECHNOLOGY PARK STE 109
LAKE MARY FL
32746-7107
US

IV. Provider business mailing address

9066 OVERLOOK PASS DR
WINDERMERE FL
34786-9537
US

V. Phone/Fax

Practice location:
  • Phone: 407-647-2346
  • Fax:
Mailing address:
  • Phone: 407-257-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11038642
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: