MEDICARE: DR. ARIEL FERNANDEZ D.O.

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	207R00000X	Internal Medicine Physician	OS19018	FL

General Provider Information

NPI Number	:	1639313091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARIEL FERNANDEZ D.O.

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR STE 303
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	904-745-3618
Fax Number	:

Provider Business Practice Location Address
First Line	:	1037 S STATE ROAD 7 STE 211
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6139
Country	:	US
Telephone Number	:	561-798-3030
Fax Number	:	561-798-8242

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

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	11/07/2024

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