# FLORENDA L. FORTNER, M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Internal Medicine & Clinical Anti-Aging Center LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659567071
- **Authorized official:** FLORENDA L. FORTNER M.D. (M.D.)
- **Authorized official phone:** (727) 841-0700

## Contact information

- **Practice address:** 5535 GRAND BLVD, SUITE C, NEW PORT RICHEY, FL 34652
- **Practice address phone:** (727) 841-0700
- **Practice address fax:** (727) 841-6969
- **Mailing address:** 5535 GRAND BLVD, SUITE C, NEW PORT RICHEY, FL 34652
- **Mailing address phone:** (727) 841-0700
- **Mailing address fax:** (727) 841-6969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | ME86987 | FL | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 03/02/2023