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General NPI Number Information
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NPI Number | 1073929345
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Entity Type | Organization
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Legal Business Name | JOSE FERNANDEZ, M.D.P.A.
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 10700 CARIBBEAN BLVD SUITE # 108
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City | CUTLER BAY
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State | FL
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Zip | 33189-1232
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Country | US
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Telephone | 305-251-8016
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Fax | 305-251-8017
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Provider Business Mailing Address
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Address Line | 10700 CARIBBEAN BLVD SUITE # 108
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City | CUTLER BAY
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State | FL
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Zip | 33189-1232
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Country | US
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Telephone | 305-251-8016
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Fax | 305-251-8017
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE FERNANDEZ
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Credential | M.D.
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Telephone | 305-251-8016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME65542
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License Number State | FL
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