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General NPI Number Information
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NPI Number | 1285961482
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Entity Type | Organization
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Legal Business Name | LATIN FOUNDATION FOR HEALTH, INC.
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 721 OAK COMMONS BLVD B
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City | KISSIMMEE
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State | FL
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Zip | 34741-4186
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Country | US
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Telephone | 407-350-7955
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Fax | 407-350-3373
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Provider Business Mailing Address
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Address Line | 8260 W FLAGLER ST 2M
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City | MIAMI
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State | FL
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Zip | 33144-2069
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Country | US
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Telephone | 305-903-9711
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Fax | 305-228-1940
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ROBERTO A FERNANDEZ
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Credential | M.D.
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Telephone | 407-350-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ACN259
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ACN277
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License Number State | FL
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