Provider Demographics
NPI:1518728781
Name:FERNANDEZ, ARIANNA (MHSC, PA-C)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MHSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16061 SW 104TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3175
Mailing Address - Country:US
Mailing Address - Phone:786-863-5588
Mailing Address - Fax:
Practice Address - Street 1:16061 SW 104TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3175
Practice Address - Country:US
Practice Address - Phone:786-863-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9118187363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant