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General NPI Number Information
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NPI Number | 1144579129
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Entity Type | Individual
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Provider Name | GIL J FERNANDEZ MS
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Gender | Male
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 14445 7TH ST
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City | DADE CITY
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State | FL
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Zip | 33523-3126
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Country | US
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Telephone | 813-553-9150
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Fax |
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Provider Business Mailing Address
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Address Line | 12410 FORT KING RD
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City | DADE CITY
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State | FL
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Zip | 33525-5611
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Country | US
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Telephone | 786-315-1512
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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