Provider Demographics
NPI:1942874664
Name:RICHARDSON, LUIS ARMANDO (APRN)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ARMANDO
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 EL VEDADO AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-1610
Mailing Address - Country:US
Mailing Address - Phone:786-253-6732
Mailing Address - Fax:
Practice Address - Street 1:618 EL VEDADO AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1610
Practice Address - Country:US
Practice Address - Phone:786-253-6732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily