Healthcare Provider Details

I. General information

NPI: 1598428492
Provider Name (Legal Business Name): LAUREN O'BOYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 RESEARCH PKWY STE 300
ORLANDO FL
32826-3265
US

IV. Provider business mailing address

12201 RESEARCH PKWY STE 300
ORLANDO FL
32826-3265
US

V. Phone/Fax

Practice location:
  • Phone: 407-823-2744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11022807
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: