Individual provider Active NPI

Daniel Rodolfo Fernandez, D.C.

  • Chiropractor
  • Homestead, FL
National Provider Identifier
1477570042
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH-8207 Issued in FL
Practice address
46 N Homestead Blvd
Homestead, FL 33030-7416
Phone
(305) 246-1664
Fax
(305) 248-9016
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH-8207 FL Primary

Addresses

Primary practice location

46 N Homestead Blvd
Homestead, FL 33030-7416

Mailing address

46 N Homestead Blvd
Homestead, FL 33030-7416
Phone (305) 246-1664

Other identifiers 4

IdentifierTypeStateIssuer
381449100MedicaidFL
70252OtherFLBLUE CROSS BLUE SHEILD
3974097OtherFLCIGNA
90-0063585OtherFLFIRST HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000711 FL Practitioner - Chiropractic 2860464567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH-8207FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Nov 18, 2024 Accepting new patients
Pain Relief Center of Homestead Chiropractor Past Accepting new patients

Locations

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

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477570042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 N HOMESTEAD BLVD",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307416",
            "telephone_number": "305-246-1664",
            "fax_number": "305-248-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 N HOMESTEAD BLVD",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307416",
            "telephone_number": "305-246-1664",
            "fax_number": "305-248-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DANIEL",
        "middle_name": "RODOLFO",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-8207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381449100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "70252",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3974097",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "90-0063585",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.