Healthcare Provider Details

I. General information

NPI: 1487590550
Provider Name (Legal Business Name): JENNIFER ANN DINGUS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 RAYMOND ST
ORLANDO FL
32803-8208
US

IV. Provider business mailing address

5918 BENT PINE DR APT 120
ORLANDO FL
32822-3328
US

V. Phone/Fax

Practice location:
  • Phone: 407-646-5500
  • Fax:
Mailing address:
  • Phone: 407-646-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11042566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: