Healthcare Provider Details

I. General information

NPI: 1790346047
Provider Name (Legal Business Name): ASHLEY M BRIDGES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W GORE ST STE 300
ORLANDO FL
32806-1014
US

IV. Provider business mailing address

207 W GORE ST STE 300
ORLANDO FL
32806-1014
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-8555
  • Fax: 321-841-2425
Mailing address:
  • Phone: 321-841-8555
  • Fax: 321-841-2425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11001451
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11001451
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11001451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: