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General NPI Number Information
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NPI Number | 1023743929
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Entity Type | Individual
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Provider Name | TAMIKA ALENA RILEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/24/2022
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 7780 LAKE UNDERHILL RD STE 111
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City | ORLANDO
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State | FL
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Zip | 32822-8218
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Country | US
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Telephone | 407-704-8005
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Fax | 407-704-2888
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Provider Business Mailing Address
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Address Line | 860 HARING LN
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City | MOUNT DORA
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State | FL
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Zip | 32757-8700
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Country | US
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Telephone | 646-836-2141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11020702
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License Number State | FL
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