Provider Demographics
NPI:1558868596
Name:TODOROVIC, DEANNA (ARNP, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:TODOROVIC
Suffix:
Gender:F
Credentials:ARNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 589
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4647
Mailing Address - Country:US
Mailing Address - Phone:407-303-1300
Mailing Address - Fax:407-303-1301
Practice Address - Street 1:2501 N ORANGE AVE STE 589
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4647
Practice Address - Country:US
Practice Address - Phone:407-303-1300
Practice Address - Fax:407-303-1301
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9368424363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9368424OtherNURSE PRACTITIONER LICENSE