MEDICARE: YOANA FERNANDEZ RRT

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	2279P1004X	Pulmonary Diagnostics Registered Respiratory Therapist	RT14832	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	13207	OTHER	FL	AHCA

General Provider Information

NPI Number	:	1164189940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOANA FERNANDEZ RRT

Provider Business Mailing Address
First Line	:	13911 N DALE MABRY HWY STE 108
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2414
Country	:	US
Telephone Number	:	813-964-6395
Fax Number	:	813-964-6551

Provider Business Practice Location Address
First Line	:	13911 N DALE MABRY HWY STE 108
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2414
Country	:	US
Telephone Number	:	813-964-6395
Fax Number	:	813-964-6551

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

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	12/02/2022

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