Healthcare Provider Details

I. General information

NPI: 1013696194
Provider Name (Legal Business Name): KENIA LLAUDY FERNANDEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 W STATE ROAD 436
ALTAMONTE SPRINGS FL
32714-2921
US

IV. Provider business mailing address

2400 MAITLAND CENTER PKWY STE 310
MAITLAND FL
32751-7442
US

V. Phone/Fax

Practice location:
  • Phone: 407-869-1030
  • Fax: 407-869-1025
Mailing address:
  • Phone: 407-426-4800
  • Fax: 407-426-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11027524
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11027524
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: