Healthcare Provider Details

I. General information

NPI: 1689134637
Provider Name (Legal Business Name): ANIKA NICOLE FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2019
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR STE 201
NAPLES FL
34109-0446
US

IV. Provider business mailing address

2338 IMMOKALEE RD # 186
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-260-1033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME156198
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME156198
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: