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General NPI Number Information
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NPI Number | 1598906232
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Entity Type | Individual
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Provider Name | ETTA LAYA RICH ARNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/10/2009
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 120 E PAR ST
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City | ORLANDO
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State | FL
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Zip | 32804-3943
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Country | US
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Telephone | 407-770-2002
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Fax | 407-770-1769
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Provider Business Mailing Address
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Address Line | 533 W KING ST
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City | ORLANDO
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State | FL
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Zip | 32804-4421
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Country | US
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Telephone | 407-342-8779
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Fax | 407-843-9263
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP1680082
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License Number State | FL
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