Provider Demographics
NPI:1972595668
Name:FERNANDEZ CHAVEZ, JOSE ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ALBERTO
Last Name:FERNANDEZ CHAVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5996 SW 70TH ST FL 5
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3540
Mailing Address - Country:US
Mailing Address - Phone:305-284-7577
Mailing Address - Fax:305-284-7688
Practice Address - Street 1:7029 SW 61ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3420
Practice Address - Country:US
Practice Address - Phone:786-456-8399
Practice Address - Fax:786-456-8390
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15819207R00000X, 207RH0003X
FLME96227207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine