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NPI Code Detail

MEDICARE: MRS. JACLYN VICTORIA O'KEEFE ARNP

MEDICARE: MRS. JACLYN VICTORIA O'KEEFE 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
1363LG0600XGerontology Nurse PractitionerARNP9354533FL

General Provider Information

NPI Number : 1700370384
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACLYN VICTORIA O'KEEFE ARNP
Provider Business Mailing Address
First Line : 1011 LAKE HIGHLAND DR
Second Line :
City : ORLANDO
State : FL
Zip : 32803-2513
Country : US
Telephone Number : 407-721-0545
Fax Number :
Provider Business Practice Location Address
First Line : 601 E ROLLINS ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-1273
Country : US
Telephone Number : 407-303-9819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 06/18/2018

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