Provider Demographics
NPI:1659005858
Name:A&B CLINIC MEDICAL CENTER
Entity Type:Organization
Organization Name:A&B CLINIC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN/FNP
Authorized Official - Phone:786-461-9549
Mailing Address - Street 1:10651 N KENDALL DR STE 217
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1545
Mailing Address - Country:US
Mailing Address - Phone:786-461-9549
Mailing Address - Fax:
Practice Address - Street 1:10651 N KENDALL DR STE 217
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1545
Practice Address - Country:US
Practice Address - Phone:786-461-9549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch