Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME56218 | FL |
Y | 111NI0900X | Internist | ME56218 | FL |
N | 2081P2900X | Pain Medicine | ME56218 | FL |
NPI | 1255540076 |
---|---|
Provider Name | Dr. Nestor Fernandez |
First Address | Plantation, FL 33324-1065 |
Second Address | Margate, FL 33063-5209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 17/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E74933 | (02) | FL |