Healthcare Provider Details

I. General information

NPI: 1700811247
Provider Name (Legal Business Name): CHRISTINA MARIE GILLMORE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 E HORATIO AVE STE 100
MAITLAND FL
32751-7316
US

IV. Provider business mailing address

541 E HORATIO AVE STE 100
MAITLAND FL
32751-7316
US

V. Phone/Fax

Practice location:
  • Phone: 407-622-0793
  • Fax: 407-289-4018
Mailing address:
  • Phone: 407-622-0793
  • Fax: 407-282-4018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP3370062
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: