Individual
MS. CARMEN MARIA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
13214 PALM BEACH BLVD, FORT MYERS, FL 33905-2025
(239) 694-7887
(239) 694-8941
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS12773
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014864100
—
FL
01
—
FGU25
FLORIDA BLUE
—
Enumeration date
07/10/2014
Last updated
06/07/2024
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