Individual
LEONEL FERNANDEZ FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6900 S ORANGE BLOSSOM TRL STE 402, ORLANDO, FL 32809-5734
(407) 382-9079
Mailing address
104 BRIARCLIFF DR, KISSIMMEE, FL 34758-4112
(863) 206-3890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1694
PR
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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