Provider Demographics
NPI:1598554313
Name:MOREJON FERNANDEZ, AIDA FIDELINA
Entity type:Individual
Prefix:
First Name:AIDA
Middle Name:FIDELINA
Last Name:MOREJON FERNANDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4739 CARVER ST
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2225
Mailing Address - Country:US
Mailing Address - Phone:786-298-7317
Mailing Address - Fax:
Practice Address - Street 1:4739 CARVER ST
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2225
Practice Address - Country:US
Practice Address - Phone:786-298-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician