Healthcare Provider Details

I. General information

NPI: 1760318935
Provider Name (Legal Business Name): ARIANE JAKE CABALBAL FERNANDEZ FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3895 CAPITAL REEF WAY
APOPKA FL
32712-5441
US

IV. Provider business mailing address

3895 CAPITAL REEF WAY
APOPKA FL
32712-5441
US

V. Phone/Fax

Practice location:
  • Phone: 689-242-5448
  • Fax:
Mailing address:
  • Phone: 689-242-5448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11048593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: