Healthcare Provider Details

I. General information

NPI: 1942052410
Provider Name (Legal Business Name): DELIA MARIA CONDE FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 W 9TH WAY
HIALEAH FL
33012-7296
US

IV. Provider business mailing address

3820 W 9TH WAY
HIALEAH FL
33012-7296
US

V. Phone/Fax

Practice location:
  • Phone: 786-864-0177
  • Fax:
Mailing address:
  • Phone: 786-864-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: