Individual
JOSE R FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7800 SW 87TH AVENUE, SUITE C350, MIAMI, FL 33173
(305) 271-4711
(305) 271-8732
Mailing address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME66013
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031352
PHP
FL
01
—
222103
AMERIGROUP
FL
01
—
240721
WELLCARE
FL
05
—
376115100
—
FL
Enumeration date
08/09/2006
Last updated
01/18/2019
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