MEDICARE: HECTOR FELIPE FERNANDEZ

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	207Q00000X	Family Medicine Physician	ME0061881	FL

General Provider Information

NPI Number	:	1205892601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR FELIPE FERNANDEZ

Provider Business Mailing Address
First Line	:	10817 S JOG RD STE 230
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-0912
Country	:	US
Telephone Number	:	954-346-5044
Fax Number	:	954-346-5078

Provider Business Practice Location Address
First Line	:	10817 S JOG RD STE 230
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-0912
Country	:	US
Telephone Number	:	561-634-8888
Fax Number	:	561-634-8998

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	12/29/2025

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