Individual provider Active NPI

Monica Fernandez, M.S.D

  • Prosthodontics
  • Gainesville, FL
National Provider Identifier
1013205038
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DTP531 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-0427
Phone
(352) 273-7950
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DTP531 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-0427

Mailing address

7652 SW 85TH Dr
Gainesville, FL 32608-8457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160310001860 FL Order and Referring Only - DentistPractitioner - Dentist 8022314418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DTP531FLMDProsthodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1013205038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7652 SW 85TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100427",
            "telephone_number": "352-273-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MONICA",
        "credential": "M.S.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DTP531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.