Active NPI
Freddy Ricardo Varona Fernandez, P.A.F.A.
- Surgical Assistant
- Brentwood, TN
National Provider Identifier
1114741980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 24-363
- Practice address
- 3 Maryland Farms Ste 200
Brentwood, TN 37027-5780 - Phone
- (800) 348-4565
- NPI assigned
- Nov 8, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 2862 | PR | |
| Surgical Assistant | 246ZC0007X | 24-363 | FL | Primary |
| Physician Assistant | 363A00000X | 2862 | PR |
Addresses
Primary practice location
3 Maryland Farms Ste 200
Brentwood, TN 37027-5780
Mailing address
11750 SW 40TH St
Miami, FL 33175-3530
Phone (305) 223-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2862 | PR | MD | Pharmacist |
| 24-363 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1114741980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11750 SW 40TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331753530",
"telephone_number": "305-223-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MARYLAND FARMS STE 200",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275780",
"telephone_number": "800-348-4565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARONA FERNANDEZ",
"first_name": "FREDDY",
"middle_name": "RICARDO",
"credential": "P.A.F.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-08",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "PR",
"license": "2862",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "24-363",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "2862",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.