MEDICARE: DR. JOSE J FERNANDEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	MC-149	GU
2	207RC0000X	Cardiovascular Disease Physician	8577	AZ
3	207RC0000X	Cardiovascular Disease Physician	32143	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003894726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE J FERNANDEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 810
Second Line	:
City	:	HANOVER
State	:	NH
Zip	:	03755-0810
Country	:	US
Telephone Number	:	603-308-1472
Fax Number	:

Provider Business Practice Location Address
First Line	:	2404 E RIVER RD
Second Line	:	BLD 2 STE 100
City	:	TUCSON
State	:	AZ
Zip	:	85718-6520
Country	:	US
Telephone Number	:	520-838-3540
Fax Number	:	520-325-3526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	12/10/2025

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Directions to “ DR. JOSE J FERNANDEZ MD” Practice Location

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