Provider Demographics
NPI:1972677664
Name:FERNANDEZ, ARIADNA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ARIADNA
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6073
Mailing Address - Country:US
Mailing Address - Phone:954-239-4818
Mailing Address - Fax:954-751-5044
Practice Address - Street 1:450 SW 136TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-6073
Practice Address - Country:US
Practice Address - Phone:954-239-4818
Practice Address - Fax:954-751-5044
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME152878207R00000X, 207R00000X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program