Provider Demographics
NPI:1376680744
Name:RAYMOND N. FERNANDEZ, M.D., P.C.
Entity Type:Organization
Organization Name:RAYMOND N. FERNANDEZ, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:N
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-891-8580
Mailing Address - Street 1:4198 US HIGHWAY 431 STE A
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0242
Mailing Address - Country:US
Mailing Address - Phone:256-891-8580
Mailing Address - Fax:256-891-8581
Practice Address - Street 1:4198 US HIGHWAY 431 STE A
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0242
Practice Address - Country:US
Practice Address - Phone:256-891-8580
Practice Address - Fax:256-891-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.22283207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51515286OtherBCBS OF AL PROVIDER NUMBE
ALF52246Medicare UPIN