Jennifer Efua Amoa Fynn, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

ME91920 Issued in FL

Practice address

101 Avenue O SE
Winter Haven, FL 33880-4333

Phone

(863) 294-7039

Fax

(863) 291-5963

NPI assigned

May 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment NPD
• Pediatrix Medical Group of Florida Inc

  • Pediatric Cardiology Physician
  • Sunrise, FL
  • NPI 1083711790

  Neonatal-Perinatal Medicine

  Medicare reassignment NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1386658615
  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1265585806
  NPD
• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1538106604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-303-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AVENUE O SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804333",
            "telephone_number": "863-294-7039",
            "fax_number": "863-291-5963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13535 Nemours Pkwy",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328277402",
            "country_code": "US",
            "telephone_number": "407-567-4000",
            "fax_number": "407-567-5924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "407-303-2528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 N Orange Ave Ste 446",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044644",
            "country_code": "US",
            "telephone_number": "407-303-2528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Rollins St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-303-2528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FYNN",
        "first_name": "JENNIFER",
        "middle_name": "EFUA AMOA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "AC1553237",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME91920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271289000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• From Pieces to Peace,LLC
• FST Behavioral
• James Ray Fuentes, APRN
• Lauren Nicole Fuller, APRN
• Melissa Suzanne Fulton, LMHC
• Nicholas Gable, DMD
• Carlos I Gabriel, M.D.
• Luchen Gabriel, OWNER
• Sam Gabriel
• Gahc4 Spring Haven FL TRS Sub, LLC

• Neonatal-Perinatal Medicine Physician in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Neonatal-Perinatal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.