Healthcare Provider Details

I. General information

NPI: 1093177941
Provider Name (Legal Business Name): ELIZABETH ROSE PAIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZ PAIN RN

II. Dates (important events)

Enumeration Date: 03/21/2016
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 N ORLANDO AVE STE C110
WINTER PARK FL
32789-2990
US

IV. Provider business mailing address

480 N ORLANDO AVE STE C110
WINTER PARK FL
32789-2990
US

V. Phone/Fax

Practice location:
  • Phone: 407-636-6363
  • Fax: 407-636-3094
Mailing address:
  • Phone: 407-636-6363
  • Fax: 407-636-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9332350
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: