Healthcare Provider Details

I. General information

NPI: 1093585069
Provider Name (Legal Business Name): DEBRA LEE HURTUBISE LPN, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 VETERANS WAY
ORLANDO FL
32827-7401
US

IV. Provider business mailing address

10066 BYNUM CT
ORLANDO FL
32821-8276
US

V. Phone/Fax

Practice location:
  • Phone: 407-590-4408
  • Fax:
Mailing address:
  • Phone: 321-287-4672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3254646
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: