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General NPI Number Information
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NPI Number | 1205368701
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Entity Type | Individual
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Provider Name | EDGAR SERGE FERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1012 LUCERNE TER
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City | ORLANDO
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State | FL
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Zip | 32806-1015
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Country | US
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Telephone | 407-423-1039
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Fax | 407-425-2347
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Provider Business Mailing Address
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Address Line | 1012 LUCERNE TER
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City | ORLANDO
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State | FL
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Zip | 32806-1015
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Country | US
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Telephone | 407-423-1039
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Fax | 407-425-2347
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME143670
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 72796
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 84410-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 3008
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME143670
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License Number State | FL
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