Provider Demographics
NPI:1134180797
Name:ARNELLE V ESLAVA-FERNANDEZ MD PA
Entity type:Organization
Organization Name:ARNELLE V ESLAVA-FERNANDEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNELLA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ESLAVA-FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-341-1159
Mailing Address - Street 1:204 S APOKA AVENUE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4803
Mailing Address - Country:US
Mailing Address - Phone:352-341-1159
Mailing Address - Fax:352-341-2718
Practice Address - Street 1:204 S APOKA AVENUE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4803
Practice Address - Country:US
Practice Address - Phone:352-341-1159
Practice Address - Fax:352-341-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G87908Medicare UPIN
FL16283ZMedicare ID - Type Unspecified