Provider Demographics
NPI:1184489205
Name:LUZBERT FERNANDEZ, YANET (SA-C)
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:LUZBERT FERNANDEZ
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 BARBIZON LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4229
Mailing Address - Country:US
Mailing Address - Phone:239-238-9873
Mailing Address - Fax:
Practice Address - Street 1:1240 BARBIZON LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4229
Practice Address - Country:US
Practice Address - Phone:239-238-9873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-141246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant