Provider Demographics
NPI:1083404602
Name:BRICENO, ANA M (APRN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:BRICENO
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 TWILIGHT TRL
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3247
Mailing Address - Country:US
Mailing Address - Phone:689-265-7803
Mailing Address - Fax:
Practice Address - Street 1:401 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4931
Practice Address - Country:US
Practice Address - Phone:407-674-2044
Practice Address - Fax:407-674-2049
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11039302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily