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Organization
MARTA R FERNANDEZ MD P A
Active
Organization
MARTA R FERNANDEZ MD P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTA R FERNANDEZ MD PA (PRESIDENT)
(305) 608-0524
Entity
Organization
Contact information
Practice address
2500 DEL PRADO BLVD S, CAPE CORAL, FL 33904-5750
(239) 772-1194
(239) 772-1196
Mailing address
2500 DEL PRADO BLVD S, CAPE CORAL, FL 33904-5750
(239) 772-1194
(239) 772-1196
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME90692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
268370900
MEDICAID PROVIDER
FL
01
—
ME90692
MEDICAL LICENSE
FL
Enumeration date
06/22/2007
Last updated
10/12/2011
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