Provider Demographics
NPI:1497853907
Name:FERNANDEZ FERNANDEZ & ASSOCUTES CORP
Entity Type:Organization
Organization Name:FERNANDEZ FERNANDEZ & ASSOCUTES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:BLEMILL
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-227-6497
Mailing Address - Street 1:13303 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3269
Mailing Address - Country:US
Mailing Address - Phone:305-227-6497
Mailing Address - Fax:305-551-2370
Practice Address - Street 1:13303 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3269
Practice Address - Country:US
Practice Address - Phone:305-227-6497
Practice Address - Fax:305-551-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3878Medicare ID - Type Unspecified