Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 8577 | AZ |
NPI | 1003894726 |
---|---|
Provider Name | Dr. Jose J Fernandez |
First Address | Tucson, AZ 85719-1563 |
Second Address | Tucson, AZ 85718-6520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 06/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202416 | (05) | AZ |
D43895 | (02) |