Provider Demographics
NPI:1598296824
Name:KHARBOUCH, ESPERANZA (ARNP)
Entity Type:Individual
Prefix:
First Name:ESPERANZA
Middle Name:
Last Name:KHARBOUCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13324 SUMMERTON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5509
Mailing Address - Country:US
Mailing Address - Phone:407-590-4420
Mailing Address - Fax:
Practice Address - Street 1:13324 SUMMERTON DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-5509
Practice Address - Country:US
Practice Address - Phone:407-590-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9297463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily