Provider Demographics
NPI:1831675818
Name:ENRIQUEZ, TAMARAH (MSN, ARNP, FNP)
Entity Type:Individual
Prefix:MS
First Name:TAMARAH
Middle Name:
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:MSN, ARNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 LAKE UNDERHILL RD STE 223-27
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4508
Mailing Address - Country:US
Mailing Address - Phone:407-720-3045
Mailing Address - Fax:
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 223-27
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4508
Practice Address - Country:US
Practice Address - Phone:407-720-3045
Practice Address - Fax:407-720-3042
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9392990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily