MEDICARE: DR. JULIA ISABEL FERNANDEZ M.D.

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	208D00000X	General Practice Physician	7725	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7725	OTHER	PR	PUERTO RICO STATE LICENSE
2	07159DM7	OTHER	PR	STATE LICENSE

General Provider Information

NPI Number	:	1093727125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIA ISABEL FERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	900 CALLE FORDHAM APT 3
Second Line	:	UNIVERSITY GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4817
Country	:	US
Telephone Number	:	787-764-4329
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 LAUREL SANTA JUANITA
Second Line	:	HOSPITAL REGIONAL DE BAYAMON ETS
City	:	BAYAMON
State	:	PR
Zip	:	00956-4816
Country	:	US
Telephone Number	:	787-288-6371
Fax Number	:

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

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	08/21/2014

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