MEDICARE: ROSANGELA DE LUCA GONCALO FERNANDES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist		FL

General Provider Information

NPI Number	:	1114880945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSANGELA DE LUCA GONCALO FERNANDES

Provider Business Mailing Address
First Line	:	15333 HONEYBELL DR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5061
Country	:	US
Telephone Number	:	407-922-8397
Fax Number	:

Provider Business Practice Location Address
First Line	:	15333 HONEYBELL DR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5061
Country	:	US
Telephone Number	:	407-922-8397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ ROSANGELA DE LUCA GONCALO FERNANDES ” Practice Location

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