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Organization
LUIS F FERNANDEZ MD PA
Active
Organization
LUIS F FERNANDEZ MD PA
Active
Other names
LUIS F FERNANDEZ, luis f fernandez md
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS F FERNANDEZ MD, PA (OWNER)
(941) 661-3434
Entity
Organization
Contact information
Practice address
2400 HARBOR BLVD STE 5, PORT CHARLOTTE, FL 33952-5038
(941) 764-7999
(941) 764-7039
Mailing address
PO BOX 495477, PORT CHARLOTTE, FL 33949-5477
(941) 766-1901
(941) 764-7039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10091A
MEDICARE
FL
01
—
ME0056435
STATE LICENSE
FL
Enumeration date
12/08/2021
Last updated
06/07/2022
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