Individual
LISVAN CARRERO FERNANDEZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10205 BALTIMORE AVE APT 7206, COLLEGE PARK, MD 20740-4244
(786) 659-7896
Mailing address
10205 BALTIMORE AVE APT 7206, COLLEGE PARK, MD 20740-4244
(786) 659-7896
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0101642
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/14/2022
Last updated
12/05/2024
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