Individual
CARLOS FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 383-1017
(904) 244-7730
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MFC1679
FL
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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