Healthcare Provider Details

I. General information

NPI: 1770314064
Provider Name (Legal Business Name): NATALIE MARIE ONCEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11948 BALM RIVERVIEW RD FL 33569
RIVERVIEW FL
33569-6601
US

IV. Provider business mailing address

6419 ENGLISH CREEK DR
LAKELAND FL
33811-1879
US

V. Phone/Fax

Practice location:
  • Phone: 813-236-9000
  • Fax:
Mailing address:
  • Phone: 401-533-3782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number11034554
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: