Fajardo, Nino Anthony

Fajardo, Nino Anthony is an individual health care provider with primary practice located at 24323 Painter Dr , Land O Lakes FL 34639-5459. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Fajardo, Nino Anthony can be contacted via phone (863) 409-8812.

Contact Information

Primary practice address
24323 Painter Dr Land O Lakes FL 34639-5459
Phone: (863) 409-8812
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 11014439 Florida

Profile Details

NPI number 1174265268
LBN Legal business name Fajardo, Nino Anthony
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2022
Last updated Sep 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174265268 NPPES
Florida Other 2B2SJ BCBS
Florida MEDICAID 114149900 BCBS

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