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General NPI Number Information
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NPI Number | 1992630099
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Entity Type | Individual
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Provider Name | GEDENIR FIORESE
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Gender | Male
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 145 MIDDLE ST STE 1121
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City | LAKE MARY
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State | FL
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Zip | 32746-3594
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Country | US
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Telephone | 407-446-2328
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Fax |
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Provider Business Mailing Address
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Address Line | 145 MIDDLE ST STE 1121
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City | LAKE MARY
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State | FL
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Zip | 32746-3594
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Country | US
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Telephone | 407-446-2328
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTT44816
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License Number State | FL
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