Healthcare Provider Details

I. General information

NPI: 1710527056
Provider Name (Legal Business Name): ADRIJANA MIJATOVIC NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 04/19/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR STE 289
OCOEE FL
34761-3432
US

IV. Provider business mailing address

1335 SLIGH BLVD 3RD FL
ORLANDO FL
32806-1110
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-4344
  • Fax: 321-842-4784
Mailing address:
  • Phone: 321-841-9205
  • Fax: 321-842-3651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11005772
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11005772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: