Healthcare Provider Details

I. General information

NPI: 1396247730
Provider Name (Legal Business Name): HERMINE L FORTE MORRIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 DONAHUE DR
OCOEE FL
34761-5130
US

IV. Provider business mailing address

555 W STATE ROAD 434
LONGWOOD FL
32750-5119
US

V. Phone/Fax

Practice location:
  • Phone: 321-842-2994
  • Fax: 407-767-5801
Mailing address:
  • Phone: 407-767-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9207475
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9207475
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: