MEDICARE: APPOLOS PLUVIOSE

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	11039786	FL

General Provider Information

NPI Number	:	1780573535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APPOLOS PLUVIOSE

Provider Business Mailing Address
First Line	:	1815 FULLERS OAK LOOP
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2119
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 FULLERS OAK LOOP
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2119
Country	:	US
Telephone Number	:	561-460-9303
Fax Number	:

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

Provider Enumeration Date	:	06/28/2025
Last Update Date	:	06/28/2025

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Directions to “ APPOLOS PLUVIOSE ” Practice Location

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