Individual
DR. INTI FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
9804 SW 40TH ST, MIAMI, FL 33165-3912
(305) 222-9199
(305) 222-9155
Mailing address
PO BOX 347768, CORAL GABLES, FL 33234-7768
(305) 903-7142
(305) 512-0082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME 97323
FL
208D00000X
General Practice Physician
Primary
ME97323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007660200
—
FL
01
—
AG020B
GROUP MEDICARE
FL
01
—
AG060W
IND MCARE PROVIDER NUMBER
FL
01
—
ME97323
STATE LICENSE
FL
Enumeration date
10/13/2006
Last updated
08/21/2024
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