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NPI Code Detail

MEDICARE: MR. ANTHONY FERNANDEZ LCSW

MEDICARE: MR. ANTHONY FERNANDEZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023181377
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTHONY FERNANDEZ LCSW
Provider Business Mailing Address
First Line : 6390 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-3517
Country : US
Telephone Number : 520-284-7949
Fax Number :
Provider Business Practice Location Address
First Line : 6390 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-3517
Country : US
Telephone Number : 520-284-7949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/25/2024

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