Individual
DR. DIANNE MICHELLE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4800 4TH ST N, SAINT PETERSBURG, FL 33703-3817
(727) 528-1133
(727) 527-3750
Mailing address
421 48TH AVE N, SAINT PETERSBURG, FL 33703-3824
(727) 527-6095
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0005777
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39666
BCBS PROVIDER NUMBER
FL
Enumeration date
01/10/2007
Last updated
07/08/2007
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