PHOENIX FULLENWIDER – Marriage & Family Therapist, NPI 1417817875

PHOENIX FULLENWIDER is a healthcare provider. based in Ocoee, Florida. specializing in Marriage & Family Therapist. The NPI Number for PHOENIX FULLENWIDER is 1417817875

Main info

Female
Sole Proprietor
Name
PHOENIX FULLENWIDER
NPI
1417817875
Phone
(321) 464-9672
Address
630 FORTANINI CIR
Enumeration Date
17 November 2025
Last Update Date
17 November 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience15
Completeness85
Years active:0State licenses:0Digital endpointsOther names

Provider Addresses for PHOENIX FULLENWIDER

  • 630 FORTANINI CIR

    OCOEE, FL 347615077

    Phone: (321) 464-9672

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34761)

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Reviews

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Frequently asked questions

What unique ID ties claims to PHOENIX FULLENWIDER?
NPI 1417817875 is assigned to PHOENIX FULLENWIDER under the national enumeration system.
Is PHOENIX FULLENWIDER's NPI currently valid?
The extract we use shows PHOENIX FULLENWIDER as active.
Does PHOENIX FULLENWIDER list a primary specialty?
If you are matching referrals, note Marriage & Family Therapist for PHOENIX FULLENWIDER. Clinical services aligned with this taxonomy classification.
Where is PHOENIX FULLENWIDER's primary listing?
We display Ocoee, Florida because that is what the record indicates for PHOENIX FULLENWIDER.
Is PHOENIX FULLENWIDER a real provider?
This page reflects official NPPES data for NPI 1417817875. Always confirm identity and privileges with the practice and licensing boards.

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