Healthcare Provider Details

I. General information

NPI: 1972285542
Provider Name (Legal Business Name): ESENCIAL WALK-IN & PRIMARY CARE CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 N SEMORAN BLVD
ORLANDO FL
32807-3330
US

IV. Provider business mailing address

630 N SEMORAN BLVD
ORLANDO FL
32807-3330
US

V. Phone/Fax

Practice location:
  • Phone: 407-635-0074
  • Fax:
Mailing address:
  • Phone: 407-635-0074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CIARA M. RIOS
Title or Position: MEDICAL PROVIDER
Credential: FNP
Phone: 407-635-0074