| Organization Name: | M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC |
| NPI Number: | 1245381052 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MANUEL F FERNANDEZ (OWNER) |
| Mailing Address: | 29613 Sw 162nd Ave Homestead |
| State: | FL US |
| Postal Code: | 330333328 |
| Phone Number: | 3052457787 |
| Fax Number: | 3052457740 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 07/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME66369 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |