Provider Demographics
NPI:1255500880
Name:FERNANDEZ, AMBER EVE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:EVE
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:EVE
Other - Last Name:CORNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:13670 WALSINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3532
Mailing Address - Country:US
Mailing Address - Phone:727-593-9848
Mailing Address - Fax:727-593-9848
Practice Address - Street 1:13670 WALSINGHAM RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3532
Practice Address - Country:US
Practice Address - Phone:727-593-9848
Practice Address - Fax:727-593-9848
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9180097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLKIBS7OtherBLUE CROSS BLUE SHIELD