Healthcare Provider Details

I. General information

NPI: 1528970928
Provider Name (Legal Business Name): ANDREA LEE MAIORINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST
ORLANDO FL
32806-2009
US

IV. Provider business mailing address

620 MOJAVE TRL
MAITLAND FL
32751-3836
US

V. Phone/Fax

Practice location:
  • Phone: 407-802-7404
  • Fax:
Mailing address:
  • Phone: 407-802-7404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number9444881
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: