Provider Demographics
NPI:1902840150
Name:FERNANDEZ ARAUJO, ANNEMARIE (MS)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:FERNANDEZ ARAUJO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ANNEMARIE
Other - Middle Name:
Other - Last Name:ARAUJO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:14224 SW 276TH WAY
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8829
Mailing Address - Country:US
Mailing Address - Phone:305-244-3363
Mailing Address - Fax:
Practice Address - Street 1:4355 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7666
Practice Address - Country:US
Practice Address - Phone:786-332-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10488101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL763155300Medicaid