Healthcare Provider Details

I. General information

NPI: 1356694798
Provider Name (Legal Business Name): ELIZABETH BORELLI MSN, ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11399 LAKE UNDERHILL RD
ORLANDO FL
32825-5023
US

IV. Provider business mailing address

10373 STONE GLEN DR
ORLANDO FL
32825-8534
US

V. Phone/Fax

Practice location:
  • Phone: 407-207-6768
  • Fax: 407-249-5025
Mailing address:
  • Phone: 407-592-7983
  • Fax: 407-249-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 9245710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: