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General NPI Number Information
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NPI Number | 1659567071
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Entity Type | Organization
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Legal Business Name | FLORENDA L. FORTNER, M.D., LLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 5535 GRAND BLVD SUITE C
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652
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Country | US
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Telephone | 727-841-0700
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Fax | 727-841-6969
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Provider Business Mailing Address
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Address Line | 5535 GRAND BLVD SUITE C
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652
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Country | US
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Telephone | 727-841-0700
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Fax | 727-841-6969
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Authorized Official
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Title or Position | M.D.
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Name | FLORENDA L. FORTNER
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Credential | M.D.
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Telephone | 727-841-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME86987
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License Number State | FL
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