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General NPI Number Information
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NPI Number | 1316810005
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Entity Type | Organization
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Legal Business Name | ENCORE FAMILY HEALTH CARE
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 911 ALLENHURST ST
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City | WINTER GARDEN
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State | FL
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Zip | 34787-3177
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Country | US
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Telephone | 321-948-1789
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Fax |
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Provider Business Mailing Address
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Address Line | 911 ALLENHURST ST
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City | WINTER GARDEN
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State | FL
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Zip | 34787-3177
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Country | US
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Telephone | 321-948-1789
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUZANNE WALLIS
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Credential | APRN
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Telephone | 321-948-1789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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