Healthcare Provider Details

I. General information

NPI: 1962930271
Provider Name (Legal Business Name): FERNANDEZ CARE AND PODIATRY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 W 16TH AVE STE 102
HIALEAH FL
33012-4645
US

IV. Provider business mailing address

3750 W 16TH AVE STE 102
HIALEAH FL
33012-4645
US

V. Phone/Fax

Practice location:
  • Phone: 786-254-7989
  • Fax: 305-640-5774
Mailing address:
  • Phone: 786-254-7989
  • Fax: 305-640-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DIAMELYS FERNANDEZ
Title or Position: OWNER
Credential:
Phone: 786-449-8559