MEDICARE: FERNANDEZ MEDICAL CARE SOLUTIONS LLC

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	207R00000X	Internal Medicine Physician

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

General Provider Information

NPI Number	:	1750867214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERNANDEZ MEDICAL CARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	PO BOX 310902
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33231-0902
Country	:	US
Telephone Number	:	312-607-1839
Fax Number	:	305-468-6364

Provider Business Practice Location Address
First Line	:	16100 NW 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6504
Country	:	US
Telephone Number	:	305-354-8800
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	CESAR A FERNANDEZ PEDEMONTE
Credential	:	MD
Telephone Number	:	312-607-1839

Provider Enumeration Date	:	07/17/2018
Last Update Date	:	07/17/2018

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