Provider Demographics
NPI:1669262176
Name:FANTAUZZI-APONTE, JAMELLY
Entity type:Individual
Prefix:
First Name:JAMELLY
Middle Name:
Last Name:FANTAUZZI-APONTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-3849
Mailing Address - Country:US
Mailing Address - Phone:813-240-0838
Mailing Address - Fax:
Practice Address - Street 1:1103 GULF OAKS DR
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-2905
Practice Address - Country:US
Practice Address - Phone:813-240-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty