Provider Demographics
NPI:1588616346
Name:HUGILL, TERESA RENEE (ARNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:RENEE
Last Name:HUGILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:232 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-1612
Mailing Address - Country:US
Mailing Address - Phone:407-428-5751
Mailing Address - Fax:407-447-7245
Practice Address - Street 1:232 N ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1612
Practice Address - Country:US
Practice Address - Phone:407-428-5751
Practice Address - Fax:407-447-7245
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3073670 00Medicaid
FL3073670 00Medicaid