MEDICARE: MICHELLE IVY ATTAR 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	363LF0000X	Family Nurse Practitioner	11006853	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346867207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE IVY ATTAR APRN

Provider Business Mailing Address
First Line	:	9685 LAKE NONA VILLAGE PL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7320
Country	:	US
Telephone Number	:	407-627-1148
Fax Number	:

Provider Business Practice Location Address
First Line	:	9685 LAKE NONA VILLAGE PL STE 205
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7322
Country	:	US
Telephone Number	:	407-627-1148
Fax Number	:

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

Provider Enumeration Date	:	06/26/2020
Last Update Date	:	05/23/2022

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