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General NPI Number Information
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NPI Number | 1649948209
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Entity Type | Organization
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Legal Business Name | NOEL DE JESUS FERNANDEZ MD PA
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 6738 W SUNRISE BLVD STE 102
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City | PLANTATION
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State | FL
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Zip | 33313-6070
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Country | US
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Telephone | 954-530-5835
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Fax | 954-337-6216
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Provider Business Mailing Address
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Address Line | 1975 W 76TH ST
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City | HIALEAH
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State | FL
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Zip | 33014-3269
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Country | US
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Telephone | 786-703-1535
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Fax | 305-397-2725
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Authorized Official
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Title or Position | COO
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Name | IRIS MARTINEZ
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Credential |
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Telephone | 786-703-1535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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