MEDICARE: DALILA FERNANDEZ MD

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	208D00000X	General Practice Physician	ACN1267	FL

General Provider Information

NPI Number	:	1568028488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALILA FERNANDEZ MD

Provider Business Mailing Address
First Line	:	2354 SURFSIDE BLVD STE D103
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-3177
Country	:	US
Telephone Number	:	239-317-7131
Fax Number	:

Provider Business Practice Location Address
First Line	:	2354 SURFSIDE BLVD STE D-103
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-3177
Country	:	US
Telephone Number	:	239-317-7131
Fax Number	:

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

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	06/05/2024

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