Healthcare Provider Details

I. General information

NPI: 1487413803
Provider Name (Legal Business Name): NEPHTALIE LESPERANCE SANON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 12/14/2024
Certification Date: 12/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4098 LIBRA DR
ORLANDO FL
32816-8026
US

IV. Provider business mailing address

4098 LIBRA DR
ORLANDO FL
32816-8026
US

V. Phone/Fax

Practice location:
  • Phone: 407-823-2701
  • Fax:
Mailing address:
  • Phone: 407-823-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23642
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: