Healthcare Provider Details

I. General information

NPI: 1811607674
Provider Name (Legal Business Name): ASHLEY NICOLE FERNANDEZ DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 GALL BLVD
ZEPHYRHILLS FL
33542-3453
US

IV. Provider business mailing address

41327 STANTON HALL DR
DADE CITY FL
33525-0708
US

V. Phone/Fax

Practice location:
  • Phone: 352-567-9084
  • Fax:
Mailing address:
  • Phone: 941-323-7744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH14310
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberCH14310
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: