1003048422 NPI number — MS. NORYS T FERNANDEZ LCSW, MSW, SAP,NBCCH

Table of content: MS. NORYS T FERNANDEZ LCSW, MSW, SAP,NBCCH (NPI 1003048422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003048422 NPI number — MS. NORYS T FERNANDEZ LCSW, MSW, SAP,NBCCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ
Provider First Name:
NORYS
Provider Middle Name:
T
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, MSW, SAP,NBCCH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERNANDEZ
Provider Other First Name:
NORYS
Provider Other Middle Name:
T
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW, MSW, SAP,NBCCH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003048422
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9055 SW 73RD CT APT 1003
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33156-2952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-669-3835
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7550 SW 57TH AVE STE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33143-5331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-669-3835
Provider Business Practice Location Address Fax Number:
305-669-3875
Provider Enumeration Date:
08/18/2009

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: 1041C0700X , with the licence number:  SW 9371 , 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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