Healthcare Provider Details

I. General information

NPI: 1891029500
Provider Name (Legal Business Name): ELIZABETH LOVE KUPFERMAN RN, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 DR. PHILLIPS BLVD. SUITE 312
ORLANDO FL
32819
US

IV. Provider business mailing address

8749 THE ESPLANADE #18
ORLANDO FL
32836-7731
US

V. Phone/Fax

Practice location:
  • Phone: 407-506-6277
  • Fax:
Mailing address:
  • Phone: 407-506-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 10047
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: