Healthcare Provider Details

I. General information

NPI: 1740447358
Provider Name (Legal Business Name): SILVIA PAOLA FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 STORRS RD
MANSFIELD CENTER CT
06250-1683
US

IV. Provider business mailing address

939 JADE CT
WESTON FL
33326-3903
US

V. Phone/Fax

Practice location:
  • Phone: 860-456-1311
  • Fax:
Mailing address:
  • Phone: 954-864-0469
  • Fax: 763-581-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberME105603
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number50640
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME105603
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number070158
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: