Healthcare Provider Details

I. General information

NPI: 1821568825
Provider Name (Legal Business Name): MAGDALENA KINGA SKOWRONSKA MSN, APRN, FNP-C, CE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date: 07/07/2026
Reactivation Date: 08/17/2026

III. Provider practice location address

740 DUNLAWTON AVE
PORT ORANGE FL
32127-4239
US

IV. Provider business mailing address

740 DUNLAWTON AVE
PORT ORANGE FL
32127-4239
US

V. Phone/Fax

Practice location:
  • Phone: 386-763-1000
  • Fax: 386-763-0507
Mailing address:
  • Phone: 386-763-1000
  • Fax: 386-763-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11000302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: