Provider Demographics
NPI:1760930309
Name:GOPAL, SWAPNA (FNP-C)
Entity Type:Individual
Prefix:
First Name:SWAPNA
Middle Name:
Last Name:GOPAL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11832 SHELTERING PINE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-8830
Mailing Address - Country:US
Mailing Address - Phone:407-920-1882
Mailing Address - Fax:407-801-9989
Practice Address - Street 1:11832 SHELTERING PINE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-8830
Practice Address - Country:US
Practice Address - Phone:407-920-1882
Practice Address - Fax:407-801-9989
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9222067363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily