Provider Demographics
NPI:1205033131
Name:FERNANDEZ-MESTRES, MARIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:E
Last Name:FERNANDEZ-MESTRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3001 W. HALLANDALE BCH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33009
Mailing Address - Country:US
Mailing Address - Phone:954-456-4888
Mailing Address - Fax:954-456-9721
Practice Address - Street 1:3001 W. HALLANDALE BCH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HALLANDALE
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:954-456-4888
Practice Address - Fax:954-456-9721
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111842207VX0000X, 207V00000X
PR25974 R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016004900Medicaid