Healthcare Provider Details

I. General information

NPI: 1235454141
Provider Name (Legal Business Name): ALYN CRISTINA CASAL-FERNANDEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 W INDIANTOWN RD STE 6
JUPITER FL
33458-7563
US

IV. Provider business mailing address

110 FRONT ST STE 300
JUPITER FL
33477-5095
US

V. Phone/Fax

Practice location:
  • Phone: 866-884-2904
  • Fax: 800-792-9021
Mailing address:
  • Phone: 866-884-2904
  • Fax: 800-792-9021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME115447
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME115447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: