Healthcare Provider Details

I. General information

NPI: 1619128162
Provider Name (Legal Business Name): FRANCES ELIZABETH FONGKIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 01/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 NE 19TH DRIVE
OKEECHOBEE FL
34972
US

IV. Provider business mailing address

208 NE 19TH DRIVE
OKEECHOBEE FL
34972
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-6431
  • Fax: 863-763-2319
Mailing address:
  • Phone: 863-763-6431
  • Fax: 863-763-2319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1649792
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: