Healthcare Provider Details

I. General information

NPI: 1629100557
Provider Name (Legal Business Name): ELEANOR A TOWNS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 W CENTRAL BLVD
ORLANDO FL
32805-1809
US

IV. Provider business mailing address

832 W CENTRAL BLVD
ORLANDO FL
32805-1809
US

V. Phone/Fax

Practice location:
  • Phone: 407-836-7185
  • Fax: 407-836-7119
Mailing address:
  • Phone: 407-296-5140
  • Fax: 407-296-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN1403302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: