Healthcare Provider Details

I. General information

NPI: 1154281905
Provider Name (Legal Business Name): ELAINE DE CARVALHO MACEDO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5749 WESTGATE DR STE 206
ORLANDO FL
32835-5040
US

IV. Provider business mailing address

5749 WESTGATE DR STE 206
ORLANDO FL
32835-5040
US

V. Phone/Fax

Practice location:
  • Phone: 689-332-7801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11043651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: