Healthcare Provider Details

I. General information

NPI: 1346627650
Provider Name (Legal Business Name): OPA PHYSICIAN PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 INTERNATIONAL PKWY SUITE 2000
LAKE MARY FL
32746-5096
US

IV. Provider business mailing address

1540 INTERNATIONAL PKWY SUITE 2000
LAKE MARY FL
32746-5096
US

V. Phone/Fax

Practice location:
  • Phone: 407-474-9253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCIS J FERNANDEZ JR.
Title or Position: MEMBER
Credential: M.D.
Phone: 407-474-9253