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General NPI Number Information
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NPI Number | 1700869674
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Entity Type | Individual
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Provider Name | CESAR A FERNANDEZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 6200 SW 73RD ST
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4679
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Country | US
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Telephone | 786-662-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 2555 PONCE DE LEON BLVD 4TH FLOOR
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City | CORAL GABLES
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State | FL
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Zip | 33134
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Country | US
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Telephone | 786-662-5252
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2782
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License Number State | FL
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