Provider Demographics
NPI:1962930271
Name:FERNANDEZ CARE AND PODIATRY SERVICES INC
Entity type:Organization
Organization Name:FERNANDEZ CARE AND PODIATRY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIAMELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-449-8559
Mailing Address - Street 1:3750 W 16TH AVE STE 138U
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4661
Mailing Address - Country:US
Mailing Address - Phone:786-449-8559
Mailing Address - Fax:305-640-5774
Practice Address - Street 1:3750 W 16TH AVE STE 138U
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4661
Practice Address - Country:US
Practice Address - Phone:786-449-8559
Practice Address - Fax:305-640-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center