Individual
LUZ M FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41135
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000576908
ANTHEM
KY
05
—
7100061280
—
KY
Enumeration date
05/17/2007
Last updated
01/25/2011
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