| Doctor Name: | DR. JUAN CARLOS FERNANDEZ |
| NPI Number: | 1275656449 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ACN258 |
| Business Practice Address: | 4618 N Armenia Ave Tampa, FL - 336032706 |
| Business Phone Number: | 8138760400 |
| Business Fax Number: | 8138760440 |
| Mailing Address: | 4618 N Armenia Ave, TAMPA |
| State: | FL |
| Postal Code: | 336032706 |
| Phone Number: | 8138760400 |
| Fax Number: | 8138760440 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 07/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ACN258 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |