Healthcare Provider Details

I. General information

NPI: 1578751533
Provider Name (Legal Business Name): AMY L FIESSINGER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 MILLENIA BLVD STE 500
ORLANDO FL
32839-6019
US

IV. Provider business mailing address

5510 N HESPERIDES ST
TAMPA FL
33614-5414
US

V. Phone/Fax

Practice location:
  • Phone: 813-467-6111
  • Fax: 813-467-6013
Mailing address:
  • Phone: 813-467-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNPP37433
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNPP37433
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR221193
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number990285
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: