OrganizationActive
1977 Enterprise LLC
NPI 1952009995 · Nurse Practitioner · Orlando, FL
Provider details
- NPI number
- 1952009995
- Entity type
- Organization
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Authorized official
- Marissa Early, Ceo
Practice location
450 S Orange Ave Fl 3
Orlando, FL 32801-3394
Phone: (407) 212-7113
Fax: (407) 264-8686
Mailing address
450 S Orange Ave Fl 3
Orlando, FL 32801-3394
Registry dates
- Enumerated
- 2023-02-20
- Last updated
- 2024-03-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.