Healthcare Provider Details

I. General information

NPI: 1023319845
Provider Name (Legal Business Name): DARCY VETRO RAVNDAL MSN, MPH, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 EDGEWATER DR
ORLANDO FL
32804-3722
US

IV. Provider business mailing address

507 STETSON ST
ORLANDO FL
32804-5831
US

V. Phone/Fax

Practice location:
  • Phone: 407-835-4900
  • Fax: 407-245-2758
Mailing address:
  • Phone: 813-760-7410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9296513
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: