# INTI FERNANDEZ MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831235043
- **Authorized official:** DR. INTI FERNANDEZ MD PA (DOCTOR)
- **Authorized official phone:** (305) 222-9154

## Contact information

- **Practice address:** 9804 SW 40TH ST, MIAMI, FL 33165-3912
- **Practice address phone:** (305) 222-9154
- **Practice address fax:** (305) 222-9155
- **Mailing address:** 5081 NW 5TH ST, MIAMI, FL 33126-3406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | ME97323 | FL | — |
| 208D00000X | General Practice Physician | ME97323 | FL | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 08/21/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 115648200 | — | FL |
| 01 | — | ME97323 | FLORIDA MD LIC\# | FL |