Healthcare Provider Details

I. General information

NPI: 1427856269
Provider Name (Legal Business Name): AYAIZA FERNANDEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9619 S DIXIE HWY
PINECREST FL
33156-2804
US

IV. Provider business mailing address

PO BOX 165154
MIAMI FL
33116-5154
US

V. Phone/Fax

Practice location:
  • Phone: 786-882-1919
  • Fax: 786-206-3161
Mailing address:
  • Phone: 786-882-1919
  • Fax: 786-206-3161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11045006
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9242644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: