Provider profile · NPI 1952009995

1977 Enterprise Llc

Nurse Practitioner · Orlando, FL · NPI 1952009995 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Nurse Practitioner

Enumerated

Feb 20, 2023

License(s)

Addresses on file

PurposeAddressCity/StatePhone
LOCATION450 S ORANGE AVE FL 3 Orlando, FL 32801-3394407-212-7113
MAILING450 S ORANGE AVE FL 3 Orlando, FL 32801-3394407-212-7113

View on NPPES registry ↗

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