Provider Demographics
NPI:1174025720
Name:FERNANDEZ UPPER EXTREMITY INSTITUTE PLLC
Entity Type:Organization
Organization Name:FERNANDEZ UPPER EXTREMITY INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-337-2003
Mailing Address - Street 1:730 GOODLETTE FRANK ROAD N
Mailing Address - Street 2:STE 204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5618
Mailing Address - Country:US
Mailing Address - Phone:239-337-2003
Mailing Address - Fax:
Practice Address - Street 1:730 GOODLETTE FRANK RD N
Practice Address - Street 2:STE 204
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5618
Practice Address - Country:US
Practice Address - Phone:239-777-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126810207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty