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General NPI Number Information
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NPI Number | 1083030761
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Entity Type | Organization
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Legal Business Name | FERNANDEZ COUNSELING SERIVCES, PA
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 7100 SW 99 AVE SUITE 203
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City | MIAMI
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State | FL
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Zip | 33173
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Country | US
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Telephone | 305-273-0000
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Fax | 305-273-0046
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Provider Business Mailing Address
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Address Line | 7100 SW 99 AVE SUITE 203
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City | MIAMI
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State | FL
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Zip | 33173
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Country | US
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Telephone | 305-273-0000
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Fax | 305-273-0046
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REBECCA FERNANDEZ
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Credential | LMHC
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Telephone | 305-273-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH592
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License Number State | FL
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