Provider Demographics
NPI:1407481757
Name:FERNANDEZ FENTE, ALFONSO (APRN FNP)
Entity Type:Individual
Prefix:MR
First Name:ALFONSO
Middle Name:
Last Name:FERNANDEZ FENTE
Suffix:
Gender:M
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4424
Mailing Address - Country:US
Mailing Address - Phone:305-823-0210
Mailing Address - Fax:305-823-0096
Practice Address - Street 1:4201 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4424
Practice Address - Country:US
Practice Address - Phone:305-823-0210
Practice Address - Fax:305-823-0096
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006441363LF0000X
FL11006441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily