Healthcare Provider Details

I. General information

NPI: 1033913504
Provider Name (Legal Business Name): DONNA G FAGARANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 CYPRESS RIDGE BLVD
WESLEY CHAPEL FL
33544-6305
US

IV. Provider business mailing address

26920 WINDING TRAIL CT
VALENCIA CA
91381-2186
US

V. Phone/Fax

Practice location:
  • Phone: 813-712-5700
  • Fax:
Mailing address:
  • Phone: 910-574-0244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: