Healthcare Provider Details

I. General information

NPI: 1114275609
Provider Name (Legal Business Name): KRISTINA ANGELA CARMICHAEL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 N MILLS AVE
ORLANDO FL
32803-5734
US

IV. Provider business mailing address

1000 E LIVINGSTON ST
ORLANDO FL
32803-5716
US

V. Phone/Fax

Practice location:
  • Phone: 407-841-1100
  • Fax:
Mailing address:
  • Phone: 407-341-2096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2834102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: