Healthcare Provider Details

I. General information

NPI: 1013605658
Provider Name (Legal Business Name): SHEKIFIRA JEWEL HUGHES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

9650 UNIVERSAL BLVD APT A205
ORLANDO FL
32819-8766
US

V. Phone/Fax

Practice location:
  • Phone: 407-897-3499
  • Fax: 407-896-9454
Mailing address:
  • Phone: 407-485-3620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024316
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: