MEDICARE: LOURDIE CHACHOUTE ARNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11011950	FL
2	363LF0000X	Family Nurse Practitioner	APRN11011950	FL

General Provider Information

NPI Number	:	1558940981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOURDIE CHACHOUTE ARNP

Provider Business Mailing Address
First Line	:	16838 CORNERWOOD DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32820-1900
Country	:	US
Telephone Number	:	407-919-5131
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 W UNDERWOOD ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-1110
Country	:	US
Telephone Number	:	407-841-5111
Fax Number	:

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

Provider Enumeration Date	:	04/04/2021
Last Update Date	:	06/22/2026

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