MEDICARE: ALFREDO FERNANDEZ, MD, PA

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	208600000X	Surgery 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	:	1861442907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFREDO FERNANDEZ, MD, PA

Provider Business Mailing Address
First Line	:	6101 WEBB RD
Second Line	:	#101
City	:	TAMPA
State	:	FL
Zip	:	33615-2872
Country	:	US
Telephone Number	:	813-496-9663
Fax Number	:	813-496-9921

Provider Business Practice Location Address
First Line	:	6101 WEBB RD
Second Line	:	#101
City	:	TAMPA
State	:	FL
Zip	:	33615-2872
Country	:	US
Telephone Number	:	813-496-9663
Fax Number	:	813-496-9921

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALFREDO FERNANDEZ
Credential	:	M.D.
Telephone Number	:	813-496-9663

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/22/2020

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