Healthcare Provider Details

I. General information

NPI: 1497757934
Provider Name (Legal Business Name): SUSAN MARIE LAWLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN MARIE NORD ARNP

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 201
ORLANDO FL
32804-4641
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 201
ORLANDO FL
32804-4641
US

V. Phone/Fax

Practice location:
  • Phone: 407-821-3620
  • Fax: 407-821-3621
Mailing address:
  • Phone: 407-821-3620
  • Fax: 407-821-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP3393782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: