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General NPI Number Information
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NPI Number | 1043648736
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Entity Type | Individual
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Provider Name | ROBERTO FERNANDEZ D.O
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Gender | Male
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 3663 S MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33133-4253
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Country | US
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Telephone | 305-854-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 10741 SW 102ND AVE
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City | MIAMI
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State | FL
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Zip | 33176-3513
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Country | US
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Telephone | 305-799-9990
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS13013
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | UO2923
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0S13013
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License Number State | FL
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