Healthcare Provider Details

I. General information

NPI: 1417869181
Provider Name (Legal Business Name): ALYSSA LYNN HALL FNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 ORANGE AVE
WINTER PARK FL
32789-4904
US

IV. Provider business mailing address

5381 VIA APPIA WAY
SANFORD FL
32771-5454
US

V. Phone/Fax

Practice location:
  • Phone: 407-907-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11050995
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: