Provider Demographics
NPI:1891060810
Name:FERNANDEZ, MARIA E
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:E
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 1:1400 NE 169TH ST APT 314
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2871
Mailing Address - Country:US
Mailing Address - Phone:786-970-6232
Mailing Address - Fax:
Practice Address - Street 1:1281 NW 6TH ST # D1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4719
Practice Address - Country:US
Practice Address - Phone:305-547-2220
Practice Address - Fax:305-547-2221
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5180989164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse