Organization
ERNESTO FUENTES MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNESTO FUENTES MD PA (PRESIDENT)
(954) 687-9745
Entity
Organization
Contact information
Practice address
601 N FLAMINGO RD, SUITE 400, PEMBROKE PINES, FL 33028-1015
(954) 687-9745
(954) 666-0668
Mailing address
2114 N FLAMINGO RD, STE 306, PEMBROKE PINES, FL 33028-3501
(954) 687-9745
(954) 666-0668
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251312900
—
FL
Enumeration date
12/20/2006
Last updated
11/22/2013
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