Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Dillingham

Individual provider Nurse Practitioner · NPI 1134840176

Ethan Dillingham is a Nurse Practitioner in Orlando, Florida. Qualified in 2022, 4 years ago. Practices with Orlando Health Medical Group Inc, a 2,137-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1222 S Orange Ave Fl 4
Orlando, FL 32806-1215
Phone: (321) 841-6444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence APRN11021751 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence 11021751 (FL)

Record details

NPI number1134840176
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 8, 2022
Last updated in NPPESOctober 14, 2022
Certification dateOctober 14, 2022
Mailing address1222 S Orange Ave Fl 4, Orlando, FL 32806-1215

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Orlando Health Medical Group Inc — 2137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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