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General NPI Number Information
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NPI Number | 1972068351
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Entity Type | Individual
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Provider Name | IDIA FERNANDEZ GIL
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Gender | Female
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Dates
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Enumeration Date | 02/09/2019
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 4938 SW 195TH TER
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City | MIRAMAR
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State | FL
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Zip | 33029-6205
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Country | US
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Telephone | 305-205-4662
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Fax |
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Provider Business Mailing Address
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Address Line | 4938 SW 195TH TER
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City | MIRAMAR
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State | FL
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Zip | 33029-6205
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Country | US
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Telephone | 305-205-4662
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9338020
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License Number State | FL
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