Provider Demographics
NPI:1235454141
Name:CASAL-FERNANDEZ, ALYN CRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALYN
Middle Name:CRISTINA
Last Name:CASAL-FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:110 FRONT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5095
Mailing Address - Country:US
Mailing Address - Phone:866-884-2904
Mailing Address - Fax:800-792-9021
Practice Address - Street 1:775 W INDIANTOWN RD STE 6
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7563
Practice Address - Country:US
Practice Address - Phone:866-884-2904
Practice Address - Fax:800-792-9021
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1154472083P0901X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME115447OtherFLORIDA MEDICAL BOARD