Provider Demographics
NPI:1891119921
Name:FERNANDEZ, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
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 1:1304 SW 160TH AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1902
Mailing Address - Country:US
Mailing Address - Phone:954-423-6893
Mailing Address - Fax:954-333-7172
Practice Address - Street 1:1304 SW 160TH AVE STE 340
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1902
Practice Address - Country:US
Practice Address - Phone:954-423-6893
Practice Address - Fax:954-333-7172
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter