Individual
MR. FERNANDO M ULLOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY STE 3803, PALM COAST, FL 32164-5982
(718) 721-1674
Mailing address
PO BOX 350137, PALM COAST, FL 32135-0137
(718) 721-1674
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
574074-1
NY
163W00000X
Registered Nurse
RN9623430
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11025366
FL
Other
Enumeration date
02/05/2009
Last updated
06/12/2025
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