Individual
DR. MARIO R FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
HIMA SAN PABLO DEL ESTE AVE CONQUISTADOR, FAJARDO, PR 00738
(787) 863-0505
Mailing address
COND CHURCHILL PARK APT F 402, SAN JUAN, PR 00926
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
16057
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7000007964
MEDIA CLAIM BILLING NUMBE
PR
Enumeration date
07/26/2006
Last updated
07/08/2007
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