Healthcare Provider Details

I. General information

NPI: 1740799683
Provider Name (Legal Business Name): CLAUDIA FERNANDEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N UNIVERSITY DR STE 107
PEMBROKE PINES FL
33024-3617
US

IV. Provider business mailing address

5630 SW 163RD AVE
SOUTHWEST RANCHES FL
33331-1446
US

V. Phone/Fax

Practice location:
  • Phone: 954-332-9400
  • Fax: 954-400-5479
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberME112453
License Number StateFL

VIII. Authorized Official

Name: DR. CLAUDIA FERNANDEZ
Title or Position: PHYSICIAN
Credential: MD
Phone: 347-579-5117