Provider Demographics
NPI:1538130935
Name:FERNANDEZ, ANA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:J6 AVE SAN PATRICIO
Mailing Address - Street 2:APT.18-E
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-4406
Mailing Address - Country:US
Mailing Address - Phone:787-487-7611
Mailing Address - Fax:
Practice Address - Street 1:PLAZA VILLA BLANCA #K-2
Practice Address - Street 2:CARR. #1
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-0534
Practice Address - Fax:787-743-0534
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR274152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist