Provider Demographics
NPI:1588248744
Name:FERNANDEZ, OFELIA
Entity type:Individual
Prefix:
First Name:OFELIA
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 W 20TH AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7519
Mailing Address - Country:US
Mailing Address - Phone:305-389-2623
Mailing Address - Fax:
Practice Address - Street 1:717 PONCE DE LEON BLVD STE 219A
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2048
Practice Address - Country:US
Practice Address - Phone:305-316-7849
Practice Address - Fax:305-397-1271
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker