Individual
OTILIA P FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11258 LEBANON RD, CINCINNATI, OH 45241-2214
(513) 563-0044
(513) 563-0061
Mailing address
4330 DRAKE RD., CINCINNATI, OH 45243
(513) 563-0044
(513) 563-0061
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-054804
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0078183
MEDICAID
OH
Enumeration date
09/13/2005
Last updated
06/08/2023
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