Provider Demographics
NPI:1053685420
Name:FORTUNE, DARLENE (DNP, ARNP)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:
Last Name:FORTUNE
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 MADRUGA AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3148
Mailing Address - Country:US
Mailing Address - Phone:305-666-8899
Mailing Address - Fax:
Practice Address - Street 1:1450 MADRUGA AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3148
Practice Address - Country:US
Practice Address - Phone:305-666-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1054872363LP0808X
FL102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst