MEDICARE: MANUEL F FERNANDEZ MD PA

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	208D00000X	General Practice Physician	ME66369	FL

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	:	1528110046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANUEL F FERNANDEZ MD PA

Provider Business Mailing Address
First Line	:	8420 W FLAGLER ST
Second Line	:	SUITE 220
City	:	MIAMI
State	:	FL
Zip	:	33144-2045
Country	:	US
Telephone Number	:	305-207-1818
Fax Number	:	305-207-1820

Provider Business Practice Location Address
First Line	:	8420 W FLAGLER ST
Second Line	:	SUITE 220
City	:	MIAMI
State	:	FL
Zip	:	33144-2045
Country	:	US
Telephone Number	:	305-207-1818
Fax Number	:	305-207-1820

Authorized Official
Title or Position	:	OWNER
Name	:	MANUEL F FERNANDEZ
Credential	:	MD
Telephone Number	:	305-207-1818

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	04/04/2014

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