Healthcare Provider Details

I. General information

NPI: 1508678715
Provider Name (Legal Business Name): KATHLEEN ALISHA JARAMILLO ZUNIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 NEMOURS PKWY
ORLANDO FL
32827-7884
US

IV. Provider business mailing address

2386 DAMMAR ST
ORLANDO FL
32824-4510
US

V. Phone/Fax

Practice location:
  • Phone: 407-567-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN95339756
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11038152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: