Individual
DR. CONNIE AILEEN FAUNTLEROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4445 S SEMORAN BLVD STE A, ORLANDO, FL 32822-2472
(407) 203-8957
(407) 985-1904
Mailing address
4445 S SEMORAN BLVD STE A, ORLANDO, FL 32822-2472
(407) 203-8957
(407) 985-1904
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
ME151342
FL
208000000X
Pediatrics Physician
Primary
ME151342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111955900
—
FL
Enumeration date
04/13/2009
Last updated
02/28/2024
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