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NPI Code Detail

MEDICARE: DR. ALFREDO JOSE FERNANDEZ DMD

MEDICARE: DR. ALFREDO JOSE FERNANDEZ DMD
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
11223P0300XPeriodontics12894FL

General Provider Information

NPI Number : 1730118605
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO JOSE FERNANDEZ DMD
Provider Business Mailing Address
First Line : 6199 WINDING LAKE DR
Second Line :
City : JUPITER
State : FL
Zip : 33458-3779
Country : US
Telephone Number : 561-422-6577
Fax Number : 561-422-8595
Provider Business Practice Location Address
First Line : 3911 W ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3902
Country : US
Telephone Number : 561-498-0050
Fax Number : 561-498-0841
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2006
Last Update Date : 07/21/2022

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