Provider Demographics
NPI:1790760478
Name:KAFIE, FERNANDO E (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:E
Last Name:KAFIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11982
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32524-1982
Mailing Address - Country:US
Mailing Address - Phone:850-479-1805
Mailing Address - Fax:850-479-1829
Practice Address - Street 1:5147 N 9TH AVE STE G21
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8771
Practice Address - Country:US
Practice Address - Phone:850-969-1491
Practice Address - Fax:850-969-1443
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME814072086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912395Medicaid
AL59070257OtherBLUE CROSS BLUE SHIELD
FL770003264OtherMEDICARE RAILROAD
AL009938382Medicaid
FL260428100Medicaid
AL59187049OtherBLUE CROSS BLUE SHIELD
FLB072OtherHEALTH FIRST NETWORK
FL58070OtherBLUE CROSS BLUE SHIELD
AL59167750OtherBLUE CROSS BLUE SHIELD
AL009912385Medicaid