Individual
ENRIQUE JOSE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2902 59TH STREET W, SUITE A, BRADENTON, FL 34209-7021
(941) 795-2088
(941) 792-5139
Mailing address
2902 59TH STREET W, SUITE A, BRADENTON, FL 34209-7021
(941) 795-2088
(941) 792-5139
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME0047930
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010008466
RAILROAD MEDICARE
FL
Enumeration date
05/02/2006
Last updated
10/04/2012
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