Provider Demographics
NPI:1457179210
Name:GUEVARA, FERNANDO III (APRN)
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:GUEVARA
Suffix:III
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6899 TUSSILAGO WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3195
Mailing Address - Country:US
Mailing Address - Phone:570-996-7009
Mailing Address - Fax:
Practice Address - Street 1:6899 TUSSILAGO WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3195
Practice Address - Country:US
Practice Address - Phone:570-996-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily