Provider Demographics
NPI:1124229497
Name:FERNANDEZ, VANIA ENID (MD)
Entity type:Individual
Prefix:DR
First Name:VANIA
Middle Name:ENID
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1951 SW 172 AVENUE
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029
Mailing Address - Country:US
Mailing Address - Phone:904-399-1623
Mailing Address - Fax:
Practice Address - Street 1:2 OAKWOOD BOULEVARD
Practice Address - Street 2:SUITE 195
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020
Practice Address - Country:US
Practice Address - Phone:954-447-5206
Practice Address - Fax:954-447-5259
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98334207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine