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General NPI Number Information
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NPI Number | 1790108868
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Entity Type | Individual
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Provider Name | LESLIE P FERNANDEZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 4725 N. FEDERAL HIGHWAY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4603
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Country | US
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Telephone | 954-493-5005
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Fax | 954-938-0957
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Provider Business Mailing Address
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Address Line | PO BOX 551420
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City | FORT LAUDERDALE
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State | FL
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Zip | 33355-1420
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Country | US
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Telephone | 800-243-3839
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Fax | 855-851-4405
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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 | ARNP9276746
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License Number State | FL
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