Provider Demographics
NPI:1851067730
Name:FORNOS ARTILES, MASLEIDY (APRN)
Entity type:Individual
Prefix:
First Name:MASLEIDY
Middle Name:
Last Name:FORNOS ARTILES
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 CROSSPOINTE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-0950
Mailing Address - Country:US
Mailing Address - Phone:239-799-6950
Mailing Address - Fax:
Practice Address - Street 1:1019 CROSSPOINTE DR STE 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-0950
Practice Address - Country:US
Practice Address - Phone:239-799-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014966363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112128200Medicaid
FL112128200Medicaid