MEDICARE: DR. RAYMOND IGLECIA - FERNANDEZ MD

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
1	2084P0800X	Psychiatry Physician	0101030060	VA
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	0101030060	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	C10333	OTHER	VA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150343300	OTHER	VI	US DEPT OF LABOR
3	1043320021	OTHER	VA	NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	O86851	OTHER	VA	SENTARA

General Provider Information

NPI Number	:	1043320021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND IGLECIA - FERNANDEZ MD

Provider Business Mailing Address
First Line	:	2440 HOOKS ST
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-3514
Country	:	US
Telephone Number	:	352-394-0833
Fax Number	:	352-394-0367

Provider Business Practice Location Address
First Line	:	2440 HOOKS ST
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-3514
Country	:	US
Telephone Number	:	352-394-0833
Fax Number	:	523-394-0367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/08/2026

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Directions to “ DR. RAYMOND IGLECIA - FERNANDEZ MD” Practice Location

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