Provider Demographics
NPI:1881214476
Name:FERNANDEZ, IRLEN (APRN)
Entity type:Individual
Prefix:
First Name:IRLEN
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7887 N KENDALL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7494
Mailing Address - Country:US
Mailing Address - Phone:305-273-6266
Mailing Address - Fax:305-273-6520
Practice Address - Street 1:7887 N KENDALL DR STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7494
Practice Address - Country:US
Practice Address - Phone:305-273-6266
Practice Address - Fax:305-273-6520
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006939363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty