Healthcare Provider Details

I. General information

NPI: 1922634849
Provider Name (Legal Business Name): SAMANTHA FERNANDEZ HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

515 CALIBRE WOODS DR NE # 515
ATLANTA GA
30329-3958
US

V. Phone/Fax

Practice location:
  • Phone: 832-929-0065
  • Fax:
Mailing address:
  • Phone: 832-929-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberMD2026-0335
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: