Phoenix Fullenwider, is a
Marriage & Family Therapist based in Ocoee, Florida. Phoenix Fullenwider is licensed to practice in Florida (license number ) and her current practice location is
630 Fortanini Cir, Ocoee, Florida. She can be reached at her office (for appointments etc.) via phone at
(321) 464-9672.
NPI number for Phoenix Fullenwider is 1417817875 and her current mailing address is 630 Fortanini Cir, Ocoee, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1417817875.
Healthcare Provider's Profile
| Full Name | Phoenix Fullenwider |
|---|
| Gender | Female |
|---|
| Speciality | Marriage & Family Therapist |
|---|
| Location | 630 Fortanini Cir, Ocoee, Florida |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1417817875
- Provider Enumeration Date: 11/17/2025
- Last Update Date: 11/17/2025
Medical Identifiers
Medical identifiers for Phoenix Fullenwider such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417817875 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 106H00000X | Marriage & Family Therapist | (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Phoenix Fullenwider is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Phoenix Fullenwider, 630 Fortanini Cir, Ocoee, FL 34761-5077 Ph: (321) 464-9672 | Phoenix Fullenwider, 630 Fortanini Cir, Ocoee, FL 34761-5077 Ph: (321) 464-9672 |
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