Healthcare Provider Details

I. General information

NPI: 1174458285
Provider Name (Legal Business Name): ARIEL JACLYN PAULL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 LUCERNE TER
ORLANDO FL
32806-1015
US

IV. Provider business mailing address

201 ROBIN RD
MONTICELLO FL
32344-6573
US

V. Phone/Fax

Practice location:
  • Phone: 561-301-2943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11048426
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: