Provider Demographics
NPI:1669481487
Name:FERNANDEZ, MILADY BELISA (MD)
Entity Type:Individual
Prefix:
First Name:MILADY
Middle Name:BELISA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MILADY
Other - Middle Name:FERNANDEZ
Other - Last Name:ESPINOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030
Mailing Address - Country:US
Mailing Address - Phone:305-551-1452
Mailing Address - Fax:305-594-6591
Practice Address - Street 1:38 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030
Practice Address - Country:US
Practice Address - Phone:305-551-1452
Practice Address - Fax:305-594-6591
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22733208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043421300Medicaid
FL043421300Medicaid
FLE94374Medicare UPIN