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General NPI Number Information
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NPI Number | 1619270717
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Entity Type | Individual
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Provider Name | JANESSA MARIE FUENTES ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 8950 N KENDALL DR SUITE 407W NEUROLOGICAL SURGERY
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City | MIAMI
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State | FL
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Zip | 33176-2144
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Country | US
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Telephone | 305-271-6159
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Fax | 786-533-9989
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Provider Business Mailing Address
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Address Line | PO BOX 743144
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City | ATLANTA
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State | GA
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Zip | 30374-3144
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Country | US
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Telephone | 786-594-6880
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 9233720
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9233720
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License Number State | FL
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