Healthcare Provider Details

I. General information

NPI: 1275939589
Provider Name (Legal Business Name): MARGALY VALCOURT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 COLUMBIA ST STE 201
ORLANDO FL
32806-1133
US

IV. Provider business mailing address

21 COLUMBIA ST STE 201
ORLANDO FL
32806-1133
US

V. Phone/Fax

Practice location:
  • Phone: 407-852-2760
  • Fax: 321-843-6729
Mailing address:
  • Phone: 407-852-2760
  • Fax: 321-843-6729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9268512
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9268512
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: