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General NPI Number Information
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NPI Number | 1659813418
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Entity Type | Individual
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Provider Name | ROSA INES FERNANDEZ CRNA, MBA
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Gender | Female
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 3120 CALLE PORTUGUES VILLA DOS RIOS
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City | PONCE
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State | PR
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Zip | 00730-4541
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Country | US
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Telephone | 787-341-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 7540 LANCASTER LOOP
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-9145
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 9466078
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License Number State | FL
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