Healthcare Provider Details

I. General information

NPI: 1942431184
Provider Name (Legal Business Name): SASHA L. GRIFFIN RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 N MAGNOLIA AVE
ORLANDO FL
32803-3809
US

IV. Provider business mailing address

736 N MAGNOLIA AVE
ORLANDO FL
32803-3809
US

V. Phone/Fax

Practice location:
  • Phone: 407-423-7149
  • Fax: 407-422-0470
Mailing address:
  • Phone: 407-423-7149
  • Fax: 407-422-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN9438468
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9438468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: