Healthcare Provider Details

I. General information

NPI: 1649108846
Provider Name (Legal Business Name): JOSE ABEL FERNANDEZ MARIMON NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 FUTURES DR STE 104
ORLANDO FL
32819-9096
US

IV. Provider business mailing address

7550 FUTURES DR STE 104
ORLANDO FL
32819-9096
US

V. Phone/Fax

Practice location:
  • Phone: 407-978-6400
  • Fax:
Mailing address:
  • Phone: 407-978-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN9672094
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: