MEDICARE: INGRID FERNANDEZ ARNP

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	363LF0000X	Family Nurse Practitioner	11034209	FL

General Provider Information

NPI Number	:	1508699182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGRID FERNANDEZ ARNP

Provider Business Mailing Address
First Line	:	3028 W COMANCHE AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5915
Country	:	US
Telephone Number	:	813-486-3636
Fax Number	:

Provider Business Practice Location Address
First Line	:	3522 W AZEELE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-2916
Country	:	US
Telephone Number	:	813-348-3700
Fax Number	:

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

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	08/20/2024

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