Healthcare Provider Details

I. General information

NPI: 1003229139
Provider Name (Legal Business Name): STEPHANIE LOUISE BATTAGLINI ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 HICKORY ST STE 102
MELBOURNE FL
32901-3224
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-3452
  • Fax: 321-434-3456
Mailing address:
  • Phone: 321-434-3452
  • Fax: 321-951-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9191475
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: