MEDICARE: FERNANDEZ CARE AND PODIATRY SERVICES INC

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	261Q00000X	Clinic/Center		FL
2	213ES0131X	Foot Surgery Podiatrist

General Provider Information

NPI Number	:	1962930271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERNANDEZ CARE AND PODIATRY SERVICES INC

Provider Business Mailing Address
First Line	:	3750 W 16TH AVE STE 102
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4645
Country	:	US
Telephone Number	:	786-254-7989
Fax Number	:	305-640-5774

Provider Business Practice Location Address
First Line	:	3750 W 16TH AVE STE 102
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4645
Country	:	US
Telephone Number	:	786-254-7989
Fax Number	:	305-640-5774

Authorized Official
Title or Position	:	OWNER
Name	:	DIAMELYS FERNANDEZ
Credential	:
Telephone Number	:	786-449-8559

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	10/22/2025

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