Healthcare Provider Details

I. General information

NPI: 1922241355
Provider Name (Legal Business Name): CARMELLA FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 GOODLETTE FRANK RD N STE 204
NAPLES FL
34102-5618
US

IV. Provider business mailing address

730 GOODLETTE FRANK RD N STE 204
NAPLES FL
34102-5618
US

V. Phone/Fax

Practice location:
  • Phone: 239-777-9321
  • Fax:
Mailing address:
  • Phone: 329-777-3921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME126810
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME126810
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: