Maria L Fortington, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101192 Issued in FL

Practice address

5070 Minton Rd NW
Suite 5
Palm Bay, FL 32907-1157

Phone

(321) 768-1600

Fax

(321) 799-4903

NPI assigned

Sep 26, 2005

Last updated

May 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1265428288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5070 MINTON RD NW",
            "address_2": "SUITE 5",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071157",
            "telephone_number": "321-768-1600",
            "fax_number": "321-799-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 MINTON RD NW",
            "address_2": "SUITE 5",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071157",
            "telephone_number": "321-768-1600",
            "fax_number": "321-799-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTINGTON",
        "first_name": "MARIA",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.