MEDICARE: MRS. ALISON J LAURITA 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	363LP2300X	Primary Care Nurse Practitioner	ARNP9212893	FL

General Provider Information

NPI Number	:	1811449416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALISON J LAURITA ARNP

Provider Business Mailing Address
First Line	:	3848 LONG BRANCH LN
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-4790
Country	:	US
Telephone Number	:	321-240-5871
Fax Number	:

Provider Business Practice Location Address
First Line	:	3848 LONG BRANCH LN
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-4790
Country	:	US
Telephone Number	:	321-240-5871
Fax Number	:

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

Provider Enumeration Date	:	10/29/2016
Last Update Date	:	12/28/2016

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