MEDICARE: MS. ESTHER CAMMACK FERNANDEZ APRN

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	363LF0000X	Family Nurse Practitioner	APRN1560232	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01474878	OTHER	FL	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1114922960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ESTHER CAMMACK FERNANDEZ APRN

Provider Business Mailing Address
First Line	:	3000 MEDICAL PARK DR STE 320
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-910-0027
Fax Number	:	813-971-1286

Provider Business Practice Location Address
First Line	:	3000 MEDICAL PARK DR STE 320
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-910-0027
Fax Number	:	813-971-1286

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/16/2022

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