Organization
GOLDEN ISLES NEUROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENRIQUE J FERNANDEZ MD (PRESIDENT)
(912) 261-0044
Entity
Organization
Contact information
Practice address
3226-C HAMPTON AVENUE, BRUNSWICK, GA 31520-4254
(912) 261-0044
(912) 261-0226
Mailing address
3226-C HAMPTON AVENUE, BRUNSWICK, GA 31520-4254
(912) 261-0044
(912) 261-0226
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
#036152
GA
174400000X
Specialist
036152
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
#000518647J
—
GA
05
—
000518647J
—
GA
01
—
DC3356
RAILROAD MEDICARE
GA
Enumeration date
01/02/2007
Last updated
04/22/2011
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