Provider Demographics
NPI:1427640812
Name:CARVAJAL FERNANDEZ, EDUARDO (APRN)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:CARVAJAL FERNANDEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 HILLSDALE LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7562
Mailing Address - Country:US
Mailing Address - Phone:407-279-1440
Mailing Address - Fax:
Practice Address - Street 1:3222 HILLSDALE LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7562
Practice Address - Country:US
Practice Address - Phone:407-279-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-07
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11043146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty