Provider Demographics
NPI:1043803547
Name:FERNANDEZ, MARGARITA MENENDEZ (APRN)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:MENENDEZ
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 SW 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4124
Mailing Address - Country:US
Mailing Address - Phone:305-218-6061
Mailing Address - Fax:
Practice Address - Street 1:8940 N KENDALL DR STE 101E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2166
Practice Address - Country:US
Practice Address - Phone:305-275-5677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2626992163W00000X
FLF10201502363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse