Healthcare Provider Details

I. General information

NPI: 1396309167
Provider Name (Legal Business Name): FLORENCE CHAVEZ DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2019
Last Update Date: 02/15/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 TURKEY LAKE RD
ORLANDO FL
32819-8001
US

IV. Provider business mailing address

9400 TURKEY LAKE RD
ORLANDO FL
32819-8001
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-5500
  • Fax: 321-843-5550
Mailing address:
  • Phone: 321-843-5500
  • Fax: 321-843-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11001882
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11001882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: