Provider Demographics
NPI:1083947725
Name:FERNANDEZ, PAMELA (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:ANESTESIOLOGIA RCM
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-758-0640
Mailing Address - Fax:787-758-1327
Practice Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY, UPR-MSC
Practice Address - Street 2:SCHOOL OF MEDICINE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-758-0640
Practice Address - Fax:787-758-1327
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR020778207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology