Provider Demographics
NPI:1659183127
Name:FORTUNE, RHIGUENS
Entity type:Individual
Prefix:
First Name:RHIGUENS
Middle Name:
Last Name:FORTUNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14141 BINGHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5571
Mailing Address - Country:US
Mailing Address - Phone:239-867-1797
Mailing Address - Fax:
Practice Address - Street 1:2903 7TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1483
Practice Address - Country:US
Practice Address - Phone:239-867-1797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20132951106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician