Provider Information for 1427265875
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STEPHANIE J FUENTES
Sex: Female
NPI: 1427265875
Last Updated: 2019-01-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1427265875 | ||||||||||||
| Enumeration Date | 2007-05-16 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1870 N CORPORATE LAKES BLVD UNIT 268672 HOLDING HANDS AUTISM, LLC WESTON, FL 33326-9999 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 1870 N CORPORATE LAKES BLVD UNIT 268672 HOLDING HANDS AUTISM, LLC WESTON, FL 33326-9999 United States Phone: 305-510-6423 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 10261 PINES BLVD | ||||||||||||
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