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General NPI Number Information
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NPI Number | 1568407864
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Entity Type | Organization
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Legal Business Name | ORESTES FERNANDEZ CANO MD PA
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 3934 SW 8TH ST SUITE 308
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City | CORAL GABLES
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State | FL
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Zip | 33134-2949
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Country | US
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Telephone | 305-447-4009
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Fax | 305-447-4085
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Provider Business Mailing Address
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Address Line | 3230 SW 79TH AVE
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City | MIAMI
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State | FL
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Zip | 33155-3408
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Country | US
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Telephone | 305-904-0000
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Fax | 305-661-7086
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Authorized Official
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Title or Position | OWNER
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Name | ORESTES FERNANDEZ
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Credential | M.D.
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Telephone | 305-904-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME 14403
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License Number State | FL
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