Provider Demographics
NPI:1356880918
Name:FUENTES FLORES, ANEL (BA)
Entity type:Individual
Prefix:
First Name:ANEL
Middle Name:
Last Name:FUENTES FLORES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 BRACKENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8628
Mailing Address - Country:US
Mailing Address - Phone:407-222-8145
Mailing Address - Fax:
Practice Address - Street 1:5449 S SEMORAN BLVD STE 20
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1778
Practice Address - Country:US
Practice Address - Phone:407-734-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health