Provider Demographics
NPI:1124643382
Name:FLEMING, MARILYN GONZALEZ (CNM, APRN)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:GONZALEZ
Last Name:FLEMING
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 W COUNTY ROAD 419
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-4402
Mailing Address - Country:US
Mailing Address - Phone:407-635-3291
Mailing Address - Fax:407-636-7804
Practice Address - Street 1:1890 W COUNTY ROAD 419
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-4402
Practice Address - Country:US
Practice Address - Phone:407-635-3291
Practice Address - Fax:407-636-7804
Is Sole Proprietor?:No
Enumeration Date:2020-06-13
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006945367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife