Provider Demographics
NPI:1114739547
Name:FERNANDEZ PINA, FRANK DAVID
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:DAVID
Last Name:FERNANDEZ PINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 NE 12TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-2327
Mailing Address - Country:US
Mailing Address - Phone:786-858-8742
Mailing Address - Fax:
Practice Address - Street 1:470 NE 12TH ST
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-2327
Practice Address - Country:US
Practice Address - Phone:786-858-8742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty