MEDICARE: JENNIFER FERNANDEZ NURSE PRACTITIONER

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	363LF0000X	Family Nurse Practitioner	11027796	FL

General Provider Information

NPI Number	:	1639851975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER FERNANDEZ NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	601 N FLAMINGO RD STE 401
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-1011
Country	:	US
Telephone Number	:	305-682-2580
Fax Number	:	305-705-1677

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

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	06/01/2026

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