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General NPI Number Information
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NPI Number | 1962234955
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Entity Type | Individual
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Provider Name | JEAN EDDY REFUSE APRN-FNP
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Gender | Male
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Dates
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Enumeration Date | 08/17/2024
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1781 PARK CENTER DR STE 120
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City | ORLANDO
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State | FL
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Zip | 32835-6254
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Country | US
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Telephone | 407-218-0485
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Fax | 407-826-1592
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Provider Business Mailing Address
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Address Line | 1781 PARK CENTER DR STE 120
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City | ORLANDO
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State | FL
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Zip | 32835-6254
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Country | US
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Telephone | 407-218-0485
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 24-391
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License Number State | FL
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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 | APRN11038720
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License Number State | FL
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