Active NPI
Madeline Fernandez
- Developmental Therapist
- Tampa, FL
National Provider Identifier
1700030988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 14001 Pomelo PL
Tampa, FL 33625-3170 - Phone
- (813) 842-3854
- NPI assigned
- Nov 14, 2008
- Last updated
- Sep 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | NU | Primary |
Addresses
Primary practice location
14001 Pomelo PL
Tampa, FL 33625-3170
Mailing address
14001 Pomelo PL
Tampa, FL 33625-3170
Phone (813) 842-3854
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000568400 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1700030988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14001 POMELO PL",
"city": "TAMPA",
"state": "FL",
"postal_code": "336253170",
"telephone_number": "813-842-3854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14001 POMELO PL",
"city": "TAMPA",
"state": "FL",
"postal_code": "336253170",
"telephone_number": "813-842-3854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MADELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-14",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000568400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.