Provider Demographics
NPI:1457533341
Name:JOSEPH I FERNANDEZ MD PA
Entity Type:Organization
Organization Name:JOSEPH I FERNANDEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:I
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-275-5677
Mailing Address - Street 1:9840 SW 88TH ST
Mailing Address - Street 2:SUITE 101-E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1848
Mailing Address - Country:US
Mailing Address - Phone:305-275-5677
Mailing Address - Fax:305-275-6560
Practice Address - Street 1:9840 SW 88TH ST
Practice Address - Street 2:SUITE 101-E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1848
Practice Address - Country:US
Practice Address - Phone:305-275-5677
Practice Address - Fax:305-275-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1488OtherMEDICARE