Healthcare Provider Details

I. General information

NPI: 1881674505
Provider Name (Legal Business Name): DIANNE MARIE OKONSKY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10902 DYLAN LOREN CIR
ORLANDO FL
32825-7739
US

IV. Provider business mailing address

3783 CASSIA DR
ORLANDO FL
32828-7739
US

V. Phone/Fax

Practice location:
  • Phone: 407-380-7966
  • Fax: 407-380-7988
Mailing address:
  • Phone: 407-282-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP3219652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: