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General NPI Number Information
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NPI Number | 1760991756
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Entity Type | Individual
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Provider Name | JUSTINE KURODA ARNP, CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 6277 SEA HARBOR DR
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City | ORLANDO
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State | FL
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Zip | 32821-8027
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Country | US
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Telephone | 689-210-0520
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Fax | 833-918-2164
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Provider Business Mailing Address
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Address Line | 6277 SEA HARBOR DR
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City | ORLANDO
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State | FL
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Zip | 32821-8027
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Country | US
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Telephone | 689-210-0520
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Fax | 833-918-2164
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | RN-503390-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP018031
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11006944
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License Number State | FL
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