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Individual

TIMOTHY JASON FELICIANO FERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
200 HEALTHCARE WAY UNIT 103, NORTH VENICE, FL 34275-3670
(941) 261-0160
(941) 261-0165
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
83790
GA
207RC0000X
Cardiovascular Disease Physician
83790
GA
207RC0000X
Cardiovascular Disease Physician
Primary
ME172792
FL

Other

Enumeration date
03/20/2017
Last updated
03/12/2026
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