Healthcare Provider Details

I. General information

NPI: 1679528566
Provider Name (Legal Business Name): LEESA SUZANNE LANKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEE SUZANNE COX CRNP

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N ORANGE AVE STE 700
ORLANDO FL
32804-5521
US

IV. Provider business mailing address

2415 N ORANGE AVE STE 700
ORLANDO FL
32804-5521
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2474
  • Fax: 407-303-0680
Mailing address:
  • Phone: 407-303-2474
  • Fax: 407-303-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9299653
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP06124
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR118899
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberR118899
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11015673
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: