Provider Demographics
NPI:1306379847
Name:ORALLO, JOSEPH P (APRN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:ORALLO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:P
Other - Last Name:ORALLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:900 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4368
Practice Address - Country:US
Practice Address - Phone:904-249-0335
Practice Address - Fax:904-390-7495
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9295417363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner