MEDICARE: HOPE LAUREN WATERMAN A.R.N.P.

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	363LF0000X	Family Nurse Practitioner	9292696	FL

General Provider Information

NPI Number	:	1205170347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOPE LAUREN WATERMAN A.R.N.P.

Provider Business Mailing Address
First Line	:	1022 W STATE ROAD 436
Second Line	:	SUITE 1006
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2900
Country	:	US
Telephone Number	:	407-774-7781
Fax Number	:	407-774-7743

Provider Business Practice Location Address
First Line	:	1022 W STATE ROAD 436
Second Line	:	SUITE 1006
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2900
Country	:	US
Telephone Number	:	407-774-7781
Fax Number	:	407-774-7743

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

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	11/15/2012

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