1932263159 NPI number — DANIEL R. FERNANDEZ, D.C., P.A.

Table of content: (NPI 1932263159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932263159 NPI number — DANIEL R. FERNANDEZ, D.C., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL R. FERNANDEZ, D.C., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932263159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46 N HOMESTEAD BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOMESTEAD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33030-7416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-246-1664
Provider Business Mailing Address Fax Number:
305-248-9016

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46 N HOMESTEAD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33030-7416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-246-1664
Provider Business Practice Location Address Fax Number:
305-248-9016
Provider Enumeration Date:
12/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FERNANDEZ
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
RODOLFO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-246-1664

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH8207 , 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)





Copyright © 2007-2025 www.npivalidator.com