Healthcare Provider Details

I. General information

NPI: 1891397998
Provider Name (Legal Business Name): MICHELLE SURIEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 S SEMORAN BLVD
ORLANDO FL
32807-4334
US

IV. Provider business mailing address

12879 SUNSTONE AVE APT 4102
ORLANDO FL
32832-6264
US

V. Phone/Fax

Practice location:
  • Phone: 407-277-0550
  • Fax:
Mailing address:
  • Phone: 321-609-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11010057
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11010057
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberAPRN11010057
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: