Individual provider Active NPI

Mirtha E Fernandez

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1508753138
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11038255 Issued in FL
Practice address
2601 Englewood Ave
Louisville, KY 40220-1126
Phone
(786) 539-6978
NPI assigned
Jun 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11038255 FL Primary

Addresses

Primary practice location

2601 Englewood Ave
Louisville, KY 40220-1126

Mailing address

2601 Englewood Ave
Louisville, KY 40220-1126
Phone (786) 539-6978

Other practice location 1

2601 Englewood Ave
Louisville, KY 40220-1126
Phone (786) 539-6978

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

LicenseStateTypeSpecialty
11038255FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1508753138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ENGLEWOOD AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201126",
            "telephone_number": "786-539-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ENGLEWOOD AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201126",
            "telephone_number": "786-539-6978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Englewood Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402201126",
            "country_code": "US",
            "telephone_number": "786-539-6978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MIRTHA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11038255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.