Healthcare Provider Details

I. General information

NPI: 1932023751
Provider Name (Legal Business Name): SHANTELE FLETCHER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40100 HIGHWAY 27
DAVENPORT FL
33837-5906
US

IV. Provider business mailing address

1270 RED HILL RD
DAVENPORT FL
33837-8662
US

V. Phone/Fax

Practice location:
  • Phone: 863-419-2278
  • Fax:
Mailing address:
  • Phone: 954-465-3405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberAPRN11049813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: