Individual provider Active NPI

Itzel Fernandez, M.D.

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1447505334
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME123072 Issued in FL
Practice address
1400 NW 12TH Ave
Miami, FL 33136-1003
Phone
(305) 243-1959
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME123072 FL Primary

Addresses

Primary practice location

1400 NW 12TH Ave
Miami, FL 33136-1003

Mailing address

1400 NW 12TH Ave
Miami, FL 33136-1003
Phone (305) 243-1959

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006001649 FL Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 7810205168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leon Medical Centers LLCGroup PAC ID 9537066618, 108 clinicians

Practice addresses (Care Compare)

2020 W 64TH St
Hialeah, FL 33016-2607
Phone (305) 907-4147

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Oct 30, 2018 Accepting new patients

Locations

8600 NW 41st St
Doral, FL 33166
Phone (305) 642-1511

2020 W 64th St
Hialeah, FL 33016
Phone (305) 631-5924

11501 SW 40th St
Miami, FL 33165
Phone (305) 646-3716

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1447505334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-243-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-243-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ITZEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME123072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.