MEDICARE: GRACE SHIM CHOE DNP, APRN, FNP-BC

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	APRN11007729	FL

General Provider Information

NPI Number	:	1912525171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE SHIM CHOE DNP, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	8601 PISA DR APT 1432
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-2153
Country	:	US
Telephone Number	:	813-486-3367
Fax Number	:

Provider Business Practice Location Address
First Line	:	8601 PISA DR APT 1432
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-2153
Country	:	US
Telephone Number	:	813-486-3367
Fax Number	:

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

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	07/13/2020

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