Provider Demographics
NPI:1114922960
Name:FERNANDEZ, ESTHER CAMMACK (APRN)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:CAMMACK
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 1:3000 MEDICAL PARK DR STE 320
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4681
Mailing Address - Country:US
Mailing Address - Phone:813-910-0027
Mailing Address - Fax:813-971-1286
Practice Address - Street 1:3000 MEDICAL PARK DR STE 320
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4681
Practice Address - Country:US
Practice Address - Phone:813-910-0027
Practice Address - Fax:813-971-1286
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1560232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01474878OtherRR MEDICARE
FL014666500Medicaid
FLP01474878OtherRR MEDICARE