Provider Demographics
NPI:1821270810
Name:INNA UDALL ARNP LLC
Entity Type:Organization
Organization Name:INNA UDALL ARNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-366-9060
Mailing Address - Street 1:1425 S OSPREY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2938
Mailing Address - Country:US
Mailing Address - Phone:941-366-9060
Mailing Address - Fax:941-552-1588
Practice Address - Street 1:1771 RINGLING BLVD
Practice Address - Street 2:610
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6869
Practice Address - Country:US
Practice Address - Phone:941-366-9060
Practice Address - Fax:941-552-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9163344251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care