MEDICARE: WILFRED P FERNANDEZ M.D.

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	208VP0000X	Pain Medicine Physician	ME50322	FL
2	207R00000X	Internal Medicine Physician	ME50322	FL

General Provider Information

NPI Number	:	1598886426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILFRED P FERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	9720 SW 90TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2950
Country	:	US
Telephone Number	:	305-742-5515
Fax Number	:

Provider Business Practice Location Address
First Line	:	2722 NE 1ST ST STE 2
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-4934
Country	:	US
Telephone Number	:	954-247-9324
Fax Number	:	844-840-8030

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	06/01/2026

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