Fanny Pena

NPI #1144454190 in Orlando, Florida

Provider Information

NPI Number: 1144454190
Entity Type: Individual
Name: Fanny Pena
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: May 5, 2009
Last Updated: May 5, 2009

Practice Location

Address: 2815 ATHERTON DR
City: Orlando
State: Florida
ZIP Code: 32824-4219
Phone: (917) 439-3762

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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