MEDICARE: MS. MISTY A ORR REGISTERED NURSE

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	163W00000X	Registered Nurse	9416453	FL

General Provider Information

NPI Number	:	1912717414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MISTY A ORR REGISTERED NURSE

Provider Business Mailing Address
First Line	:	1530 HOLLY AVE
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32952-5884
Country	:	US
Telephone Number	:	321-427-4939
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N US HIGHWAY 17 92 STE 24
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-3624
Country	:	US
Telephone Number	:	407-876-6699
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	01/08/2025

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