Provider Demographics
NPI:1669727848
Name:HERIBERTO FERNANDEZ MD PA
Entity type:Organization
Organization Name:HERIBERTO FERNANDEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERIBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-420-5016
Mailing Address - Street 1:777 E 25TH ST STE 509
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3834
Mailing Address - Country:US
Mailing Address - Phone:305-420-5016
Mailing Address - Fax:786-452-9901
Practice Address - Street 1:777 E 25TH ST STE 509
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3834
Practice Address - Country:US
Practice Address - Phone:305-420-5016
Practice Address - Fax:786-452-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty