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NPI Code Detail

MEDICARE: RAIDY PENA FERNANDEZ

MEDICARE: RAIDY PENA FERNANDEZ
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
1363LA2100XAcute Care Nurse PractitionerAPRN11045234FL

General Provider Information

NPI Number : 1467303859
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAIDY PENA FERNANDEZ
Provider Business Mailing Address
First Line : 409 BRIAR BAY CIR
Second Line :
City : ORLANDO
State : FL
Zip : 32825-5967
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9400 TURKEY LAKE RD
Second Line :
City : ORLANDO
State : FL
Zip : 32819-8001
Country : US
Telephone Number : 407-351-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ RAIDY PENA FERNANDEZ ” Practice Location

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