Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | FL PY 7672 | FL |
N | 103TC0700X | Clinical Psychologist | FL PY 7672 | FL |
N | 102L00000X | Psychologist | PY 7672 | FL |
N | 103T00000X | Psychologist | PY 7672 | FL |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY 7672 | FL |
N | 103TA0700X | Adult Development & Aging Psychologist | PY 7672 | FL |
Y | 103G00000X | Clinical Psychologist | FL PY 7672 | FL |
Y | 103TC0700X | Clinical Psychologist | FL PY 7672 | FL |
N | 103TC1900X | Counseling Psychologist | PY 7672 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY 7672 | FL |
N | 103TF0200X | Forensic Psychologist | PY 7672 | FL |
N | 103TM1800X | Intellectual & Developmental Disabilities | PY 7672 | FL |
NPI | 1518148543 |
---|---|
Provider Name | Dr. Richard Elias Fernandez |
First Address | Miami, FL 33131 |
Second Address | Miami, FL 33131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2007 |
Last Update Date | 01/02/2012 |