Individual
DR. LUIS FERNANDEZ DE LA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 QUINCY AVE, 5TH FL, SCRANTON, PA 18510-1798
(570) 340-2552
(570) 340-2446
Mailing address
700 QUINCY AVE, 5TH FL, SCRANTON, PA 18510-1798
(570) 770-7546
(570) 770-7545
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD071376L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001845744
—
PA
Enumeration date
06/07/2007
Last updated
08/20/2013
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