MEDICARE: CHRISTINA FERNANDES

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	363A00000X	Physician Assistant		FL

General Provider Information

NPI Number	:	1902733561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA FERNANDES

Provider Business Mailing Address
First Line	:	11252 PADDOCK MANOR AVE
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-2210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11252 PADDOCK MANOR AVE
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-2210
Country	:	US
Telephone Number	:	813-389-5437
Fax Number	:

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

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ CHRISTINA FERNANDES ” Practice Location

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