| Dainery M. Fuentes, Phd | |
|
5304 S Florida Ave Lakeland FL 33813-4918 | |
| (863) 660-0218 | |
| (863) 774-0966 |
| Full Name | Dainery M. Fuentes, Phd |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 5304 S Florida Ave, Lakeland, Florida |
| Authorized Official Name and Position | Dainery Fuentes (DIRECTOR) |
| Authorized Official Contact | 8636600218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dainery M. Fuentes, Phd 5304 S Florida Ave Lakeland FL 33813-4918 Ph: (863) 660-0218 | Dainery M. Fuentes, Phd 5304 S Florida Ave Lakeland FL 33813-4918 Ph: (863) 660-0218 |
| NPI Number | 1063953644 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 03/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063953644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY4076 (Florida) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | PY4076 (Florida) | Secondary |
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