Healthcare Provider Details

I. General information

NPI: 1972385102
Provider Name (Legal Business Name): MEREDITH ALICIA XIMINES-MULLINGS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2941 W STATE ROAD 434 STE 400
LONGWOOD FL
32779-4415
US

IV. Provider business mailing address

7008 OAKMORE LN
ORLANDO FL
32818-8808
US

V. Phone/Fax

Practice location:
  • Phone: 407-697-2175
  • Fax: 779-201-3646
Mailing address:
  • Phone: 202-749-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11029087
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: