Healthcare Provider Details

I. General information

NPI: 1952039414
Provider Name (Legal Business Name): REBECCA BARLAAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E SOUTH ST STE 100
ORLANDO FL
32801-3508
US

IV. Provider business mailing address

550 E SR 434
LONGWOOD FL
32750-5222
US

V. Phone/Fax

Practice location:
  • Phone: 407-843-1180
  • Fax: 407-841-6160
Mailing address:
  • Phone: 407-381-7367
  • Fax: 407-331-6758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11020382
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11020382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: