Provider Demographics
NPI:1275837775
Name:CORTIJO, JEANINE ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:ANN
Last Name:CORTIJO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:JEANINE
Other - Middle Name:ANN
Other - Last Name:VALENTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:339 S DEERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3763
Mailing Address - Country:US
Mailing Address - Phone:407-493-3370
Mailing Address - Fax:
Practice Address - Street 1:12280 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5009
Practice Address - Country:US
Practice Address - Phone:186-638-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3193082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily