Healthcare Provider Details

I. General information

NPI: 1487354015
Provider Name (Legal Business Name): LAUREN ELIZABETH ASHLINE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 COLUMBIA ST
ORLANDO FL
32806-1115
US

IV. Provider business mailing address

62 COLUMBIA ST
ORLANDO FL
32806-1115
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-5851
  • Fax: 321-843-1673
Mailing address:
  • Phone: 321-843-5851
  • Fax: 321-843-1673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11040386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: