Organization
M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL F FERNANDEZ MD (OWNER)
(305) 245-7787
Entity
Organization
Contact information
Practice address
29613 SW 162ND AVE, HOMESTEAD, FL 33033-3328
(305) 245-7787
(305) 245-7740
Mailing address
29613 SW 162ND AVE, HOMESTEAD, FL 33033-3328
(305) 245-7787
(305) 245-7740
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME66369
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373393901
—
FL
Enumeration date
01/16/2007
Last updated
07/01/2008
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