Healthcare Provider Details

I. General information

NPI: 1134556400
Provider Name (Legal Business Name): FERNANDA BELLODI SCHMIDT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1295 NW 14TH ST
MIAMI FL
33125-1610
US

IV. Provider business mailing address

1295 NW 14TH ST
MIAMI FL
33125-1610
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6704
  • Fax:
Mailing address:
  • Phone: 305-243-6704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.127065
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number35.127065
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.127065
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME134257
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: