Provider Demographics
NPI:1972302990
Name:LAKE-APPLETON, MONIQUE OLINA (FNP)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:OLINA
Last Name:LAKE-APPLETON
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15402 GROOSE POINT LN
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-6175
Mailing Address - Country:US
Mailing Address - Phone:407-419-6816
Mailing Address - Fax:
Practice Address - Street 1:15402 GROOSE POINT LN
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-6175
Practice Address - Country:US
Practice Address - Phone:407-419-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily