Provider Demographics
NPI:1962450072
Name:FERNANDEZ, MARIA VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:VICTORIA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:13173 SW 47TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3163
Mailing Address - Country:US
Mailing Address - Phone:305-336-6726
Mailing Address - Fax:305-821-1632
Practice Address - Street 1:3750 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4654
Practice Address - Country:US
Practice Address - Phone:305-821-1600
Practice Address - Fax:305-821-1632
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2018-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME61882208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371545101Medicaid