Doctor Name: | MR. EDDIE FERNANDEZ |
NPI Number: | 1316117872 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MT |
License Number: | 4047 |
Business Practice Address: | Carr 129 Km 21.8 Bo Callejones Lares, PR - 00669 |
Business Phone Number: | 7878970263 |
Business Fax Number: | 7878970263 |
Mailing Address: | P O Box 143233, ARECIBO |
State: | PR |
Postal Code: | 00614 |
Phone Number: | 7878970263 |
Fax Number: | 7878970263 |
NPI Enumeration Date: | 03/11/2008 |
NPI Last Update Date: | 03/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246RM2200X |
License Number: | 4047 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Pathology |
Taxonomy Specialization: | Medical Laboratory |
Taxonomy Definition: |