Provider Demographics
NPI:1407481757
Name:FERNANDEZ FENTE, ALFONSO (APRN FNP)
Entity type:Individual
Prefix:MR
First Name:ALFONSO
Middle Name:
Last Name:FERNANDEZ FENTE
Suffix:
Gender:M
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 W 16TH AVE STE 67
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7194
Mailing Address - Country:US
Mailing Address - Phone:305-826-0002
Mailing Address - Fax:786-460-0483
Practice Address - Street 1:4410 W 16TH AVE STE 67
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7194
Practice Address - Country:US
Practice Address - Phone:305-826-0002
Practice Address - Fax:786-460-0483
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006441363LF0000X
FLAPRN11006441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily