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NPI Code Detail

MEDICARE: NICOLE PELAEZ FERNANDEZ

MEDICARE: NICOLE PELAEZ 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548103070
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE PELAEZ FERNANDEZ
Provider Business Mailing Address
First Line : 4401 N HIMES AVE STE 175
Second Line :
City : TAMPA
State : FL
Zip : 33614-7095
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4401 N HIMES AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-7097
Country : US
Telephone Number : 813-393-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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Directions to “ NICOLE PELAEZ FERNANDEZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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