Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phoenix Fullenwider

Individual provider Marriage & Family Therapist · NPI 1417817875

Phoenix Fullenwider is a Marriage & Family Therapist in Ocoee, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2025

Practice location Address checks out

630 Fortanini Cir
Ocoee, FL 34761-5077
Phone: (321) 464-9672
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X (FL)

Record details

NPI number1417817875
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 17, 2025
Last updated in NPPESNovember 17, 2025
Certification dateNovember 17, 2025
Mailing address630 Fortanini Cir, Ocoee, FL 34761-5077