MEDICARE: PATRICIA M FIDDELKE NP

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	363LW0102X	Women's Health Nurse Practitioner	11002288	FL

General Provider Information

NPI Number	:	1689523987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA M FIDDELKE NP

Provider Business Mailing Address
First Line	:	1851 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-7013
Country	:	US
Telephone Number	:	407-244-5527
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-7013
Country	:	US
Telephone Number	:	407-244-5527
Fax Number	:

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

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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