1710057997 NPI number — MRS. MARIA OFELIA FERNANDEZ ARNP

Table of content: MRS. MARIA OFELIA FERNANDEZ ARNP (NPI 1710057997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710057997 NPI number — MRS. MARIA OFELIA FERNANDEZ ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ
Provider First Name:
MARIA
Provider Middle Name:
OFELIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HERNANDEZ
Provider Other First Name:
MARIA
Provider Other Middle Name:
OFELIA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1710057997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
760 EAST 11TH PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33010-3648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-888-6147
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 W FLAGLER ST
Provider Second Line Business Practice Location Address:
WHOLE HEALTH CENTER FPL WELL
Provider Business Practice Location Address City Name:
CORAL GABLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33134-1606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-569-4125
Provider Business Practice Location Address Fax Number:
305-569-4124
Provider Enumeration Date:
11/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  1612032 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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