Provider Demographics
NPI:1932927944
Name:MONTGOMERY, AUNNA LAVONNE (APRN)
Entity type:Individual
Prefix:
First Name:AUNNA
Middle Name:LAVONNE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AUNNA
Other - Middle Name:
Other - Last Name:NOGOSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 MAITLAND CENTER PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7442
Mailing Address - Country:US
Mailing Address - Phone:407-426-4800
Mailing Address - Fax:407-426-4820
Practice Address - Street 1:101 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2994
Practice Address - Country:US
Practice Address - Phone:407-505-4901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035207363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health