Provider Demographics
NPI:1750173472
Name:FLEURIMOND, MAGDA LOURDES (APRN)
Entity type:Individual
Prefix:
First Name:MAGDA
Middle Name:LOURDES
Last Name:FLEURIMOND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MAGDA
Other - Middle Name:LOURDES
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:467 BRITTEN DR
Mailing Address - Street 2:
Mailing Address - City:POINCIANA
Mailing Address - State:FL
Mailing Address - Zip Code:34758-4123
Mailing Address - Country:US
Mailing Address - Phone:407-719-5835
Mailing Address - Fax:
Practice Address - Street 1:805 E OAK ST STE 1
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4576
Practice Address - Country:US
Practice Address - Phone:407-933-0021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily