Provider Demographics
NPI:1245814490
Name:FERNANDEZ, LIVIO HELVECIO III (PA-C)
Entity type:Individual
Prefix:MR
First Name:LIVIO
Middle Name:HELVECIO
Last Name:FERNANDEZ
Suffix:III
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-594-6880
Mailing Address - Fax:
Practice Address - Street 1:8950 N KENDALL DR STE 601W
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2139
Practice Address - Country:US
Practice Address - Phone:305-271-9777
Practice Address - Fax:786-533-9518
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2022-01-30
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Provider Licenses
StateLicense IDTaxonomies
FL363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant