Provider Demographics
NPI:1710248240
Name:PERRY, LASHAWNA (ARNP)
Entity Type:Individual
Prefix:
First Name:LASHAWNA
Middle Name:
Last Name:PERRY
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 1:650 N WYMORE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2859
Mailing Address - Country:US
Mailing Address - Phone:407-644-9040
Mailing Address - Fax:407-644-9004
Practice Address - Street 1:650 N WYMORE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2859
Practice Address - Country:US
Practice Address - Phone:407-644-9040
Practice Address - Fax:407-644-9004
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9233755363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner