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Alexis Fonville

NPI Registration Record

Provider / OrganizationNPIDate Certified
ALEXIS FONVILLE14175556082020-10-11
Entity TypeIndividual
Provider Name Alexis Fonville
Practice Office Address1150 S SEMORAN BLVD STE A
ORLANDO, FL US
Practice Office Telephone4077047811
Mailing Address3445 BENSON PARK BLVD
ORLANDO, FL 328297332 US
Business Telephone6093690684
HPT Codes
CodeLicense NoState
101YP2500X
390200000X PRIMARY
OPI Codes

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