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General NPI Number Information
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NPI Number | 1386567451
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Entity Type | Individual
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Provider Name | AQUANETTA LAKISSIA FELIX CCMA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 810 WOODS AVE APT A
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City | ORLANDO
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State | FL
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Zip | 32805-3158
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Country | US
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Telephone | 407-591-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 810 WOODS AVE APT A
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City | ORLANDO
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State | FL
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Zip | 32805-3158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G4F5D9S2
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License Number State | FL
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