Individual
DR. HENRIQUE JOSE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 N GRAND AVE, SUITE 150, PUEBLO, CO 81003-2749
(719) 595-7680
(719) 595-7687
Mailing address
5820 GLADSTONE ST, COLORADO SPRINGS, CO 80906-8256
(719) 576-0263
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
48454
CO
207RG0100X
Gastroenterology Physician
98813
MT
207RG0100X
Gastroenterology Physician
MD-50732
IA
207RG0100X
Gastroenterology Physician
TRN11230
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75771055
—
CO
Enumeration date
08/27/2008
Last updated
04/24/2023
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