Provider Demographics
NPI:1619601184
Name:ALDRIN, ELAINA (APRN)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:
Last Name:ALDRIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8164 WOOD SAGE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4793
Mailing Address - Country:US
Mailing Address - Phone:407-902-7729
Mailing Address - Fax:
Practice Address - Street 1:7680 UNIVERSAL BLVD STE 130
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8900
Practice Address - Country:US
Practice Address - Phone:407-883-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020632363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner