Provider Demographics
NPI:1679747810
Name:FERNANDEZ, CLAUDIA BEATRIZ
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:BEATRIZ
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 W GRAY RD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-9772
Mailing Address - Country:US
Mailing Address - Phone:207-657-2333
Mailing Address - Fax:207-657-2062
Practice Address - Street 1:62 W GRAY RD
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-9772
Practice Address - Country:US
Practice Address - Phone:207-657-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist