Provider Demographics
NPI:1487836268
Name:FELIX, FERNANDO A (DC)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:A
Last Name:FELIX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 W CALLE DE LAS TIENDAS
Mailing Address - Street 2:#117-B
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-4235
Mailing Address - Country:US
Mailing Address - Phone:520-648-0323
Mailing Address - Fax:
Practice Address - Street 1:75 W CALLE DE LAS TIENDAS
Practice Address - Street 2:#117-B
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4235
Practice Address - Country:US
Practice Address - Phone:520-648-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101581Medicare UPIN
AZ101579Medicare PIN
AZ101578Medicare PIN
AZ101580Medicare UPIN