Provider Demographics
NPI:1740288851
Name:FERNANDEZ-MILIAN, INGRID (MD)
Entity type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:
Last Name:FERNANDEZ-MILIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CALLE 3
Mailing Address - Street 2:GARDEN HILLS ESTATES
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962-5883
Mailing Address - Country:US
Mailing Address - Phone:787-781-8619
Mailing Address - Fax:787-782-9026
Practice Address - Street 1:7135 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2802
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10674207RI0200X
PR448171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No171100000XOther Service ProvidersAcupuncturist