=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629935879
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE FERNANDEZ MARTINEZ MANAGEMENT, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2026
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 741 HIGHWAY 466
-----------------------------------------------------
City | LADY LAKE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32159-6340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-750-6650
-----------------------------------------------------
Fax | 352-750-6653
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 741 HIGHWAY 466
-----------------------------------------------------
City | LADY LAKE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32159-6340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-750-6650
-----------------------------------------------------
Fax | 352-750-6653
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. ANA DEL CAMEN FERNANDEZ LIZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-750-6650
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------