Healthcare Provider Details

I. General information

NPI: 1477905115
Provider Name (Legal Business Name): ARIAM FERNANDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FONTAINEBLEAU BLVD
MIAMI FL
33172-7018
US

IV. Provider business mailing address

175 FONTAINEBLEAU BLVD
MIAMI FL
33172-7018
US

V. Phone/Fax

Practice location:
  • Phone: 305-228-7000
  • Fax: 305-228-7009
Mailing address:
  • Phone: 305-228-7000
  • Fax: 305-228-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: