Basic Information
Provider Information
NPI: 1457990897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MERRITT
FirstName: BRITTANY
MiddleName: MAE
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 E ROLLINS ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328031248
CountryCode: US
TelephoneNumber: 4073037283
FaxNumber: 4073030347
Practice Location
Address1: 601 E ROLLINS ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328031248
CountryCode: US
TelephoneNumber: 4073037283
FaxNumber: 4073030347
Other Information
ProviderEnumerationDate: 01/02/2020
LastUpdateDate: 03/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WG0000XRN9352874FLN Nursing Service ProvidersRegistered NurseGeneral Practice
363LC0200XAPRN11006001FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
363LG0600XAPRN11006001FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

No ID Information.


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