Provider Demographics
NPI:1669841698
Name:ARCHER, REBECCA L (APRN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:ARCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 N ORANGE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4655
Mailing Address - Country:US
Mailing Address - Phone:407-898-4116
Mailing Address - Fax:407-894-1091
Practice Address - Street 1:2902 N ORANGE AVE STE D
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4655
Practice Address - Country:US
Practice Address - Phone:407-898-4116
Practice Address - Fax:407-894-1091
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9397475363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics