MEDICARE: ENCORE FAMILY HEALTH CARE

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

General Provider Information

NPI Number	:	1316810005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCORE FAMILY HEALTH CARE

Provider Business Mailing Address
First Line	:	911 ALLENHURST ST
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3177
Country	:	US
Telephone Number	:	321-948-1789
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 ALLENHURST ST
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3177
Country	:	US
Telephone Number	:	321-948-1789
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUZANNE WALLIS
Credential	:	APRN
Telephone Number	:	321-948-1789

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	09/29/2025

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Directions to “ENCORE FAMILY HEALTH CARE ” Practice Location

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