Individual provider Active NPI

Judeline Docteur, ARNP

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1295031094
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9204734 Issued in FL
Practice address
5308 W Irlo Bronson Memorial Hwy
Kissimmee, FL 34746-4754
Phone
(407) 390-9185
NPI assigned
Jan 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9204734 FL Primary

Addresses

Primary practice location

5308 W Irlo Bronson Memorial Hwy
Kissimmee, FL 34746-4754

Mailing address

11354 Aries Dr
Orlando, FL 32837-9002
Phone (407) 729-5903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000528 FL Practitioner - Nurse Practitioner 0345427456 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9204734FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Inc. CurrentSince Apr 16, 2025 Accepting new patients
Grow Healthcare Group PA CurrentSince Jan 7, 2025 Accepting new patients
First Knight Medical Inc PastSince Nov 7, 2006 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1295031094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11354 ARIES DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328379002",
            "telephone_number": "407-729-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 W IRLO BRONSON MEMORIAL HWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347464754",
            "telephone_number": "407-390-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCTEUR",
        "first_name": "JUDELINE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9204734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.