MEDICARE: DAYKER ALFREDO FERNANDEZ PA

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1225859523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYKER ALFREDO FERNANDEZ PA

Provider Business Mailing Address
First Line	:	17339 BLOOMING FIELDS DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17339 BLOOMING FIELDS DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7222
Country	:	US
Telephone Number	:	305-608-8741
Fax Number	:

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

Provider Enumeration Date	:	10/18/2024
Last Update Date	:	10/18/2024

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