Healthcare Provider Details

I. General information

NPI: 1598608184
Provider Name (Legal Business Name): HEATHER LEE-KREGEL TRAYLOR MSN, RN APRN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 KUHL AVE STE 320
ORLANDO FL
32806-2013
US

IV. Provider business mailing address

10225 SPRING MOSS AVE
CLERMONT FL
34711-6438
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-4344
  • Fax:
Mailing address:
  • Phone: 407-902-8957
  • Fax: 407-902-8957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11045972
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: