Active NPI
Augusto Fajardo, APRN
- Family Nurse Practitioner
- Davenport, FL
National Provider Identifier
1093573693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11031703
- Practice address
- 40107 Highway 27
Davenport, FL 33837-5901 - Phone
- (863) 420-8384
- Fax
- (352) 243-6614
- NPI assigned
- Mar 8, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11031703 | FL | Primary |
Addresses
Primary practice location
40107 Highway 27
Davenport, FL 33837-5901
Mailing address
40107 Highway 27
Davenport, FL 33837-5901
Phone (863) 420-8384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11031703 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775001600000",
"number": "1093573693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40107 HIGHWAY 27",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338375901",
"telephone_number": "863-420-8384",
"fax_number": "352-243-6614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40107 HIGHWAY 27",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338375901",
"telephone_number": "863-420-8384",
"fax_number": "352-243-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAJARDO",
"first_name": "AUGUSTO",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-08",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11031703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, FL
- Everstead Home Care LLC
- Excel Pain and Spine LLC
- Excelsior Coaching Services
- Extrait Health, PLLC
- Eye Doctors Optical Outlets, PA
- Family Care Physician Group
- Family Tree Medical Group II, PA
- Adrian Nicole Faniel-Wormley, APRN
- Fast Track Urgent Care LLC (Fast Track Urgent Care)
- Bensley Faustin, PHARMACIST
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.