Individual provider Active NPI

Laura Fontanez, ARNP

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1326233347
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9198021 Issued in FL
Practice address
3400 Quadrangle Blvd
Orlando, FL 32817
Phone
(407) 266-3627
Fax
(407) 882-4799
NPI assigned
Sep 12, 2007
Last updated
Apr 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9198021 FL Primary

Addresses

Primary practice location

3400 Quadrangle Blvd
Orlando, FL 32817

Mailing address

3400 Quadrangle Blvd
Orlando, FL 32817-1492
Phone (407) 266-3627

Other practice location 1

9907 Universal Blvd
Orlando, FL 32819-8701
Phone (407) 996-4560

Other identifiers 1

IdentifierTypeStateIssuer
020028300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071210000436 FL Practitioner - Nurse Practitioner 3375632656 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9198021FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Central Florida Board of Trustees CurrentSince Apr 23, 2017 Accepting new patients
The University of Central Florida Board of Trustees CurrentSince Apr 23, 2017 Accepting new patients

Locations

3400 Quadrangle Blvd
Orlando, FL 32817
Phone (407) 266-3627

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1326233347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 QUADRANGLE BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328171492",
            "telephone_number": "407-266-3627",
            "fax_number": "407-882-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 QUADRANGLE BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32817",
            "telephone_number": "407-266-3627",
            "fax_number": "407-882-4799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9907 Universal Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328198701",
            "country_code": "US",
            "telephone_number": "407-996-4560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTANEZ",
        "first_name": "LAURA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9198021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020028300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.