Provider Demographics
NPI:1851281513
Name:DISBROW, AUSTIN JAY (RN)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAY
Last Name:DISBROW
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W HARDING ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3904
Mailing Address - Country:US
Mailing Address - Phone:386-341-6334
Mailing Address - Fax:
Practice Address - Street 1:65 W HARDING ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3904
Practice Address - Country:US
Practice Address - Phone:386-341-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9629946163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine