Healthcare Provider Details

I. General information

NPI: 1376473660
Provider Name (Legal Business Name): ANA CAROLINA PEREIRA FONSECA GUEDES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14393 BRIDGEWATER CROSSINGS BLVD
WINDERMERE FL
34786-3259
US

IV. Provider business mailing address

5457 NEW INDEPENDENCE PKWY
WINTER GARDEN FL
34787-8781
US

V. Phone/Fax

Practice location:
  • Phone: 516-784-7255
  • Fax:
Mailing address:
  • Phone: 321-389-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: