Healthcare Provider Details

I. General information

NPI: 1568914232
Provider Name (Legal Business Name): LAKESHIA NECOLE SCOTT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10250 SE 167TH PLACE ROAD SUITE 5
SUMMERFIELD FL
34491
US

IV. Provider business mailing address

1821 INKWOOD CT
ORLANDO FL
32818-5830
US

V. Phone/Fax

Practice location:
  • Phone: 352-307-9925
  • Fax: 352-307-8442
Mailing address:
  • Phone: 407-970-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9188580
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: