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General NPI Number Information
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NPI Number | 1629872585
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Entity Type | Individual
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Provider Name | AUGUSTO RAFAEL FERNANDEZ ARISTI MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2799 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48202-2608
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Country | US
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Telephone | 313-916-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 10467 NW 82ND ST UNIT 17
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City | DORAL
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State | FL
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Zip | 33178-4402
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Country | US
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Telephone | 813-504-9442
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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