MEDICARE: DR. ALBERT C FERNANDEZ LCSW, PHD

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	1041C0700X	Clinical Social Worker	SW3108	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	:	1558384628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT C FERNANDEZ LCSW, PHD

Provider Business Mailing Address
First Line	:	2114 N FLAMINGO RD STE 205
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-3501
Country	:	US
Telephone Number	:	305-778-6381
Fax Number	:	954-885-0638

Provider Business Practice Location Address
First Line	:	2114 N FLAMINGO RD STE 205
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-3501
Country	:	US
Telephone Number	:	305-778-6381
Fax Number	:	954-885-0638

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	12/28/2010

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