M F Fernandez MD Kelly Medical Center Co Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME66369 Issued in FL

Legal business name

M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC

Practice address

29613 SW 162ND Ave
Homestead, FL 33033-3328

Phone

(305) 245-7787

Fax

(305) 245-7740

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Manuel F Fernandez, MDNPI 1265402051

Title

Owner

Phone

(305) 245-7787

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manuel Francisco Fernandez, MEDICAL DOCTOR

  • General Practice Physician
  • Miami, FL
  • NPI 1265402051
  NPD (past) Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1245381052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29613 SW 162ND AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330333328",
            "telephone_number": "305-245-7787",
            "fax_number": "305-245-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29613 SW 162ND AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330333328",
            "telephone_number": "305-245-7787",
            "fax_number": "305-245-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M F FERNANDEZ MD KELLY MEDICAL CENTER CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-245-7787",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME66369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373393901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynnexia Health Group LLC
• M & B Therapy Services, LLC
• M & B Therapy Services, LLC
• M & J Quality Care
• M & K Smart Kids Therapy LLC
• M&J Quality Care, LLC
• Ma Quality Services Inc
• Jose Antonio Maceda II, NP-C
• Maylin Maceo
• Machado Cardio Diagnostics Inc

• General Practice Physician in Homestead, FL
• Providers in Homestead, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.