Provider Demographics
NPI:1740839620
Name:FERNANDEZ, PIEDAD CECILIA
Entity type:Individual
Prefix:MRS
First Name:PIEDAD
Middle Name:CECILIA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 NW 31ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-6138
Mailing Address - Country:US
Mailing Address - Phone:305-987-4538
Mailing Address - Fax:
Practice Address - Street 1:1491 NW 31ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6138
Practice Address - Country:US
Practice Address - Phone:305-987-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider