Healthcare Provider Details

I. General information

NPI: 1295475580
Provider Name (Legal Business Name): NATALIE BOREN APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/01/2022
Certification Date: 04/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 340
ORLANDO FL
32804-4601
US

IV. Provider business mailing address

1317 ZEEK RIDGE ST
CLERMONT FL
34715-0057
US

V. Phone/Fax

Practice location:
  • Phone: 407-895-8890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017936
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: