MEDICARE: ELAINE DE CARVALHO MACEDO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	APRN11043651	FL

General Provider Information

NPI Number	:	1154281905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE DE CARVALHO MACEDO APRN

Provider Business Mailing Address
First Line	:	2295 S HIAWASSEE RD STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-8748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2295 S HIAWASSEE RD STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-8748
Country	:	US
Telephone Number	:	689-332-7801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	06/27/2026

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