Healthcare Provider Details

I. General information

NPI: 1972235372
Provider Name (Legal Business Name): NATACHA ANNE JULES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. NATACHA ANNE JOSEPH

II. Dates (important events)

Enumeration Date: 06/26/2022
Last Update Date: 06/26/2022
Certification Date: 06/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 FARLAND DR
OCOEE FL
34761-4403
US

IV. Provider business mailing address

3161 FARLAND DR
OCOEE FL
34761-4403
US

V. Phone/Fax

Practice location:
  • Phone: 954-303-6281
  • Fax:
Mailing address:
  • Phone: 954-303-6281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11014071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: