Male or Other

Mr. Dennis L. Fortner P.A.

Medical Physician Assistant in Ormond Beach, FL(View on Map)

Full Name

Mr. Dennis Leroy Fortner P.A.

NPI Number

1891092771

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/11/2011

Specialties

(Taxonomies)

Code

363AM0700X
363A00000X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA9105894

Contact
Information

Purpose

Mailing
Location

Address

298 S YONGE ST
298 S YONGE ST

City

Ormond Beach
Ormond Beach

State

FL
FL

Postal Code

32174-6264
32174-6264

Country

US
US

Telephone Number

(386) 479-2151
(386) 479-2151

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/16/2016

Provider Address

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