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General NPI Number Information
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NPI Number | 1992642755
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Entity Type | Individual
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Provider Name | JESSICA FONSECA APRN
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Gender | Female
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 1900 N MILLS AVE STE 107
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City | ORLANDO
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State | FL
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Zip | 32803-1460
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Country | US
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Telephone | 407-894-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 743 CLAY ST APT 458
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City | WINTER PARK
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State | FL
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Zip | 32789-4694
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11045208
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License Number State | FL
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