Provider Demographics
NPI:1144747791
Name:MCINERNEY, KATALINA FERNANDEZ (PHD)
Entity Type:Individual
Prefix:
First Name:KATALINA
Middle Name:FERNANDEZ
Last Name:MCINERNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 NW 14TH ST STE 604
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2117
Mailing Address - Country:US
Mailing Address - Phone:305-243-7529
Mailing Address - Fax:
Practice Address - Street 1:1150 NW 14TH ST STE 604
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2117
Practice Address - Country:US
Practice Address - Phone:305-243-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9945103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist