Provider Demographics
NPI:1669493995
Name:TAPIA, FERNANDO (M D)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:TAPIA
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 E ALTAMONTE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4811
Mailing Address - Country:US
Mailing Address - Phone:407-831-7000
Mailing Address - Fax:407-831-5077
Practice Address - Street 1:616 E ALTAMONTE DR STE 101
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4811
Practice Address - Country:US
Practice Address - Phone:407-831-7000
Practice Address - Fax:407-831-5077
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0022216207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E56668Medicare UPIN
FL48858Medicare ID - Type Unspecified