Healthcare Provider Details

I. General information

NPI: 1699062463
Provider Name (Legal Business Name): JORDANA ISABEL REINA FERNANDEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PLACE STE 208
CELEBRATION FL
34747-5434
US

IV. Provider business mailing address

410 CELEBRATION PLACE STE 208
CELEBRATION FL
34747-5434
US

V. Phone/Fax

Practice location:
  • Phone: 877-800-0239
  • Fax: 407-566-2499
Mailing address:
  • Phone: 877-800-0239
  • Fax: 407-566-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD455311
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME132411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: