Provider Demographics
NPI:1811133234
Name:FERNANDEZ, ORLANDO (MD)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4061 BONITA BEACH RD
Mailing Address - Street 2:STE 101
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4074
Mailing Address - Country:US
Mailing Address - Phone:239-301-0105
Mailing Address - Fax:239-301-0110
Practice Address - Street 1:4061 BONITA BEACH RD
Practice Address - Street 2:STE 101
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4074
Practice Address - Country:US
Practice Address - Phone:239-301-0105
Practice Address - Fax:239-301-0110
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113113207RE0101X
TXN7084207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism