Luis F Fernandez MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LUIS F FERNANDEZ MD PA

Practice address

2400 Harbor Blvd Ste 5
Port Charlotte, FL 33952-5038

Phone

(941) 764-7999

Fax

(941) 764-7039

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Luis F Fernandez, MD, PANPI 1932190394

Title

Owner

Phone

(941) 661-3434

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• luis f fernandez md Former legal business name
• LUIS F FERNANDEZ Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Luis F Fernandez, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
  • NPI 1932190394
  Medicare reassignment NPD Authorized official
• Lisa Marie Ferrentino, ARNP

  • Family Nurse Practitioner
  • Port Charlotte, FL
  • NPI 1366141475
  NPD

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1861150773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495477",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339495477",
            "telephone_number": "941-766-1901",
            "fax_number": "941-764-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD STE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525038",
            "telephone_number": "941-764-7999",
            "fax_number": "941-764-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS F FERNANDEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-661-3434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "10091A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME0056435",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "luis f fernandez md",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "LUIS F FERNANDEZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Todd Michael Lovero, O.D.
• LP Port Charlotte LLC (Signature HealthCARE of Port Charlotte)
• Kenneth Lloyd Luberger Jr.
• Stacey Luczejko, ED.S, MA, LPC, NCC
• Katherine Ann Ludeman, ARNP
• Luis Fernandez, MD
• Luis G Marmol MD PA
• Randyel Luis, RPH
• Matthew Luttrell
• Lonnie Luu, MD

• Internal Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.