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General NPI Number Information
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NPI Number | 1073896338
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Entity Type | Individual
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Provider Name | ELIZABETH JUSTINE DEBERRY C.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 7350 SANDLAKE COMMONS BLVD STE 1100
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City | ORLANDO
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State | FL
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Zip | 32819-8031
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Country | US
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Telephone | 407-636-2437
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Fax |
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Provider Business Mailing Address
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Address Line | 133 BENMORE DR STE 100
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City | WINTER PARK
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State | FL
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Zip | 32792-4111
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Country | US
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Telephone | 689-232-5086
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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 | APRN9423760
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License Number State | FL
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