Healthcare Provider Details

I. General information

NPI: 1548553936
Provider Name (Legal Business Name): RACHEL PERRICONE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 GLENWOOD DR
WINTER PARK FL
32792-3310
US

IV. Provider business mailing address

PO BOX 1031
ORLANDO FL
32802-1031
US

V. Phone/Fax

Practice location:
  • Phone: 407-646-7777
  • Fax: 407-629-9098
Mailing address:
  • Phone: 407-872-7786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1953762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: