Healthcare Provider Details

I. General information

NPI: 1275544231
Provider Name (Legal Business Name): WILLARD HOUSTON PITTS ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 CROWN POINT WOODS CIR
OCOEE FL
34761-3700
US

IV. Provider business mailing address

1780 CROWN POINT WOODS CIR
OCOEE FL
34761-3700
US

V. Phone/Fax

Practice location:
  • Phone: 407-656-4015
  • Fax: 407-656-4879
Mailing address:
  • Phone: 407-656-4015
  • Fax: 407-656-4879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP479762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: