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General NPI Number Information
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NPI Number | 1477106052
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Entity Type | Individual
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Provider Name | TARA LYNN ALFRED APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 6900 TURKEY LAKE RD STE 1-1
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City | ORLANDO
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State | FL
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Zip | 32819-4707
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Country | US
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Telephone | 407-370-9783
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Fax |
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Provider Business Mailing Address
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Address Line | 804 EMMETT ST
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City | KISSIMMEE
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State | FL
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Zip | 34741-5434
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Country | US
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Telephone | 407-785-1111
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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 | APRN11002918
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License Number State | FL
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