Healthcare Provider Details

I. General information

NPI: 1063854875
Provider Name (Legal Business Name): ALAINA CORY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

92 W MILLER ST
ORLANDO FL
32806-2032
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-8588
  • Fax: 321-841-8560
Mailing address:
  • Phone: 321-841-8588
  • Fax: 321-841-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11006796
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1-110833
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: