Provider Demographics
NPI:1891246930
Name:FERNANDEZ PODIATRY INC
Entity Type:Organization
Organization Name:FERNANDEZ PODIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAMELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-449-8559
Mailing Address - Street 1:730 SE 8 ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010
Mailing Address - Country:US
Mailing Address - Phone:786-449-8559
Mailing Address - Fax:
Practice Address - Street 1:730 SE 8TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5646
Practice Address - Country:US
Practice Address - Phone:786-449-8559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty