MEDICARE: RAYMOND N 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	207RC0000X	Cardiovascular Disease Physician	00022283	AL

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
2	51515286	OTHER	AL	BCBS OF ALABAMA

General Provider Information

NPI Number	:	1699774141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND N FERNANDEZ MD

Provider Business Mailing Address
First Line	:	4198 US HIGHWAY 431
Second Line	:	SUITE A
City	:	ALBERTVILLE
State	:	AL
Zip	:	35950-0212
Country	:	US
Telephone Number	:	256-891-8580
Fax Number	:	256-891-8581

Provider Business Practice Location Address
First Line	:	4198 US HIGHWAY 431
Second Line	:	SUITE A
City	:	ALBERTVILLE
State	:	AL
Zip	:	35950-0212
Country	:	US
Telephone Number	:	256-891-8580
Fax Number	:	256-891-8581

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	10/15/2007

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