Provider Demographics
NPI:1124423918
Name:PHILIP, ANOOJA (ARNP)
Entity type:Individual
Prefix:
First Name:ANOOJA
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 W ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3482
Mailing Address - Country:US
Mailing Address - Phone:407-884-2952
Mailing Address - Fax:407-884-9352
Practice Address - Street 1:1049 W ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3482
Practice Address - Country:US
Practice Address - Phone:407-884-2952
Practice Address - Fax:407-884-9352
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9228348363L00000X
FLARNP9228348363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9228348OtherMEDICAL LICENSE
FL014048700Medicaid