Healthcare Provider Details

I. General information

NPI: 1093941700
Provider Name (Legal Business Name): CASSANDRA ABOY FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSANDRA LOUISE ABOY

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 UTAH AVE STE 200
EL SEGUNDO CA
90245-4817
US

IV. Provider business mailing address

2700 UNIVERSITY SQUARE DR
TAMPA FL
33612-5513
US

V. Phone/Fax

Practice location:
  • Phone: 281-766-0959
  • Fax:
Mailing address:
  • Phone: 813-253-2721
  • Fax: 813-253-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberME119161
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME119161
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: