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General NPI Number Information
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NPI Number | 1023528478
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Entity Type | Individual
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Provider Name | JULIO FERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | 3909 NE 163RD ST STE 303
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33160-4126
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Country | US
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Telephone | 305-871-3601
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 NW 192ND AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2922
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Country | US
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Telephone | 786-201-8374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 20074
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License Number State | FL
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