MEDICARE: AILEN GARCES FERNANDEZ APRN

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	207W00000X	Ophthalmology Physician	11046309	FL

General Provider Information

NPI Number	:	1689515256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEN GARCES FERNANDEZ APRN

Provider Business Mailing Address
First Line	:	1165 SW 117TH WAY
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33325-3942
Country	:	US
Telephone Number	:	843-817-6591
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1003
Country	:	US
Telephone Number	:	843-817-6591
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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