Provider Demographics
NPI:1164453767
Name:FERNANDEZ BARRERAS, MIGUEL OSVALDO (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:OSVALDO
Last Name:FERNANDEZ BARRERAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E 4TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3504
Mailing Address - Country:US
Mailing Address - Phone:305-746-0334
Mailing Address - Fax:
Practice Address - Street 1:1401 E 4TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3504
Practice Address - Country:US
Practice Address - Phone:305-888-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1220207P00000X, 208D00000X
PR8065207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine