Healthcare Provider Details

I. General information

NPI: 1700305000
Provider Name (Legal Business Name): OMNIA FERNANDEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11686 NW 89TH PL
HIALEAH GARDENS FL
33018-4153
US

IV. Provider business mailing address

11686 NW 89TH PL
HIALEAH GARDENS FL
33018-4153
US

V. Phone/Fax

Practice location:
  • Phone: 786-278-3307
  • Fax:
Mailing address:
  • Phone: 786-278-3307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9348184
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9348184
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: