Individual provider Active NPI

Alfredo J Fernandez, M.D.

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1912252107
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME142805 Issued in FL
Practice address
3430 W Lambright St Ste 101
Tampa, FL 33614-4750
Phone
(813) 877-4201
Fax
(727) 498-0672
NPI assigned
Jul 13, 2012
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME142805 FL Primary

Addresses

Primary practice location

3430 W Lambright St Ste 101
Tampa, FL 33614-4750

Mailing address

3430 W Lambright St Ste 101
Tampa, FL 33614-4750
Phone (813) 877-4201

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
I20130401000381 FL Practitioner - General Practice 1850536475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3430 W Lambright St
Suite 101
Tampa, FL 33614-4750
Phone (813) 877-4201

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iditalya 10 Medical Center Inc General Practice CurrentSince May 24, 2015 Accepting new patients
Jose C Dominguez MD PA Past Accepting new patients
Clear Scope Healthcare LLC PastSince Oct 9, 2015 Accepting new patients

Locations

3430 W Lambright St
Ste 101
Tampa, FL 33614
Phone (813) 877-4201

4600 N Habana Ave
Ste 20
Tampa, FL 33614
Phone (813) 877-4201

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1912252107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 W LAMBRIGHT ST STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336144750",
            "telephone_number": "813-877-4201",
            "fax_number": "727-498-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 W LAMBRIGHT ST STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336144750",
            "telephone_number": "813-877-4201",
            "fax_number": "727-498-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ALFREDO",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME142805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.