MEDICARE: MS. DEBITA TEJWANTIE BADRI ARNP C

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	ARNP2016692	FL

General Provider Information

NPI Number	:	1205814985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBITA TEJWANTIE BADRI ARNP C

Provider Business Mailing Address
First Line	:	2747 GRANTHAM CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6170
Country	:	US
Telephone Number	:	407-292-5596
Fax Number	:

Provider Business Practice Location Address
First Line	:	7599 W SAND LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-5109
Country	:	US
Telephone Number	:	407-353-1177
Fax Number	:

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	04/23/2014

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