MEDICARE: CAROLINA MARIE FERNANDEZ

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	235Z00000X	Speech-Language Pathologist	SA18140	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

General Provider Information

NPI Number	:	1467060442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA MARIE FERNANDEZ

Provider Business Mailing Address
First Line	:	248 NW 42ND AVE FL 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5481
Country	:	US
Telephone Number	:	786-441-6647
Fax Number	:	786-329-6464

Provider Business Practice Location Address
First Line	:	248 NW 42ND AVE FL 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5481
Country	:	US
Telephone Number	:	786-441-6647
Fax Number	:	786-329-6464

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

Provider Enumeration Date	:	07/16/2020
Last Update Date	:	02/17/2026

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Directions to “ CAROLINA MARIE FERNANDEZ ” Practice Location

Language	Start Address	Practice Location

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