Healthcare Provider Details

I. General information

NPI: 1902733561
Provider Name (Legal Business Name): CHRISTINA FERNANDES PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5985 SILVER FALLS RUN STE 100
BRADENTON FL
34211-1291
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 941-202-2055
  • Fax: 877-550-1635
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9121819
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: