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NPI 1609270685

NPI 1609270685 : FLORENCE FERNANDEZ : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1609270685
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    Entity Type          |    Individual 
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    Provider Name        |    FLORENCE FERNANDEZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/20/2014
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    Last Update Date     |    09/14/2015
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Provider Practice Location Address
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    Address Line         |    2051 MARENGO ST 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90033-1352
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    Country              |    US
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    Telephone            |    323-409-1694
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26404 VERMONT AVENUE UNIT 15
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    City                 |    HARBOR CITY
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    State                |    CA
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    Zip                  |    90710-3404
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    Country              |    US
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    Telephone            |    
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    693868
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    License Number State |    CA
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