Healthcare Provider Details

I. General information

NPI: 1396726030
Provider Name (Legal Business Name): ELIZABETH J READ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4051 THOMASSA CT
ORLANDO FL
32812-5866
US

IV. Provider business mailing address

3318 ROYAL ASCOT RUN PO BOX 672
GOTHA FL
34734-5116
US

V. Phone/Fax

Practice location:
  • Phone: 407-579-9371
  • Fax: 407-295-1041
Mailing address:
  • Phone: 407-443-9092
  • Fax: 407-295-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP1474932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: