Provider Demographics
NPI:1659813418
Name:FERNANDEZ, ROSA INES (CRNA, MBA)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:INES
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:CRNA, MBA
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:INES
Other - Last Name:CORREA VELEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:7540 LANCASTER LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-9145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3120 CALLE PORTUGUES
Practice Address - Street 2:VILLA DOS RIOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4541
Practice Address - Country:US
Practice Address - Phone:787-341-9680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9466078367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered