Provider Demographics
NPI:1811322704
Name:ABOYME, IRENE MARIA (ARNP)
Entity type:Individual
Prefix:MISS
First Name:IRENE
Middle Name:MARIA
Last Name:ABOYME
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:IRENE MARIA
Other - Middle Name:GUTIERREZ
Other - Last Name:ABOYME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:317 WILD FORREST DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-5717
Mailing Address - Country:US
Mailing Address - Phone:407-288-7238
Mailing Address - Fax:
Practice Address - Street 1:311 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4421
Practice Address - Country:US
Practice Address - Phone:407-933-1423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3044192363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health